X marks the spot sign

The X-marks-the-spot sign of large bowel volvulus refers to the crossing loops of the bowel at the site of the transition. It has been reported to improve diagnostic confidence in detecting cecal and sigmoid volvulus. This is in contrast to the split-wall sign which indicates partial obstruction and refers to invagination or indentation of pericolic fat into the wall of the bowel in a partial twist.

This sign was first described in a paper by Jeffrey M Levsky et al in 2010 .