Colonic volvulus. The Army Medical Center experience 1983-1987

Colonic volvulus was first described in 1836 by von Rokitansky. The condition has been a formidable one, fraught with innumerable complications responsible for many deaths. Even with advances in surgical technology, mortalities have remained high. Often the diagnosis is delayed for hours or even days after presentation, and serious concomitant systemic diseases are often present. Treatment has been controversial, particularly the role of elective resection following successful nonoperative reduction. The Army Medical Center experience with colonic volvulus from 1983 through 1987 is reviewed. Fifty-four patients at the eight medical centers carried this diagnosis. Their presenting signs and symptoms are discussed. The Army patients are compared and contrasted with reviews presented in the surgical literature, and conclusions are made to give guidelines for diagnosis and treatment.