Volvulus of the colon

The results of treatment for volvulus of the colon during 13 years in a community hospital are analysed, It is concluded that sigmoid volvulus should be treated with proctoscopic examination and insertion of a rectal tube, unless signs of gangreana or peritonitis are present. In patients without accompanying sever diseases, elective resection should be performed later. Repeated tube decompressions should be attempted in patients with recurrence and high operative risk. Unsuccessful tube decompressions or signs of a non-viable colon should be followed by emergence laparotomy and, probably, resection of the sigmoid colon whether gangraena is present or not. Volvulus of the cecum should be treated with operative reduction and pexia or cecostomy, unless gangreana necessitating a hemicolectomy is present.