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Published on: September 16, 2019
[Sigma volvulus: diagnostic and therapeutic features (considerations on 10 cases)]
M Roseano1, G Guarino, A Cuviello
1Università degli Studi di Trieste Dipartimento di Scienze Chirurgiche Generali, Anestesiologiche e Medicina Intensiva Unità Clinico Operativa Clinica Chirurgica Generale e Terapia Chirurgica.
Sigmoid volvulus, a condition with high mortality, can be diagnosed via sigmoidoscopy. Treatment involves endoscopic decompression or elective surgery, with resection being preferred but sigmoidopexy also yielding good results.
Area of Science:
- Gastroenterology
- Surgical Oncology
Context:
- Sigmoid volvulus presents a significant mortality risk, particularly in elderly patients with comorbidities.
- Accurate diagnosis and effective treatment are crucial for improving patient outcomes.
Purpose:
- To evaluate diagnostic procedures and treatments for sigmoid volvulus.
- To identify optimal strategies for managing sigmoid volvulus and reducing mortality.
Summary:
- This study reviewed 10 sigmoid volvulus cases, noting abdominal pain as a common symptom and leucocytosis correlating with bowel ischemia.
- Sigmoidoscopy proved diagnostic in all cases, while plain radiographs were non-specific.
- Treatments included endoscopic decompression (3/6 success) and surgery (resection or sigmoidopexy), with an operative mortality of 14%.
Impact:
- Sigmoidoscopy followed by elective surgery offers a viable approach for diagnosing and treating sigmoid volvulus.
- While resection is the preferred treatment, derotation and sigmoidopexy can also achieve favorable outcomes.
- Improved diagnostic and treatment protocols can reduce the high mortality associated with sigmoid volvulus.
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