title: Emptiness of the left iliac fossa: a new clinical sign of sigmoid volvulus.
abstract: BACKGROUND
  Diagnostic difficulties are common in sigmoid volvulus. This diagnostic delay contributes to high morbidity and mortality.
  
  
  OBJECTIVE
  This paper recognises visible or palpable emptiness of the left iliac fossa as a new clinical sign of sigmoid volvulus. Predictive accuracy of the sign was assessed in this study.
  
  
  METHODS
  519 patients with acute abdomen of non-traumatic origin were prospectively studied.
  
  
  RESULTS
  The new sign was present in 24 out of 86 patients (28%) with sigmoid volvulus. It was absent in all those who did not have sigmoid volvulus. The positive predictive value of the sign was 100%.
  
  
  CONCLUSIONS
  Emptiness of the left iliac fossa is a valuable diagnostic adjunct. Positive sign is pathognomonic of sigmoid volvulus. Nevertheless, a negative sign warrants further investigations.
authors.affiliation: Department of Surgery, Veer Surendra Sai Medical College, Sambalpur, Orissa, India. venkatsankar@yahoo.com
authors.forename: V
authors.initials: V
authors.lastname: Raveenthiran
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis* / Q000209:etiology; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012810:Sigmoid Diseases / Q000175:diagnosis*