I read with interest the article written by Pattanakuhar and Kovindha [1], who presented a patient with sigmoid volvulus (SV) complicating tetraplegia and discussed the relationship between SV and spinal cord injury (SCI). Although SV is an uncommon disease worldwide, it is relatively common in my practicing area, Eastern Anatolia [2]. We have 55-year (June 1966–July 2021) and 1040-case experience with SV, which is the largest single-center series over the world [3]. In the light of this experience, my comments relate to the pathogenesis, diagnosis, and treatment of SV in patients with SCI.

In our series, although there was no patient with tetraplegia, two forty something males (0.2%) had paraplegia arising from SCI. Abdominal pain, distention, and obstipation were the main clinical features. SV was diagnosed with clinical examination and X-ray findings before the usage of CT in a patient, whereas, CT was used in the diagnosis of the other case. We treated a patient with endoscopic decompression, while the other case required emergency surgery including sigmoid resection with Hartmann’s procedure due to sigmoid gangrene.

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