[Volvulus of the sigmoid colon]

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Medical Diagnostics

Context:

• Sigmoid colon volvulus is a significant cause of bowel obstruction, particularly in elderly populations.
• A history of previous episodes is common, indicating a potential for recurrence.
• Diagnosis relies on clinical presentation, plain abdominal X-rays, and contrast enemas.

Purpose:

• To analyze the outcomes of different management strategies for sigmoid colon volvulus.
• To evaluate the efficacy and safety of endoscopic detorsion and intubation.
• To compare the mortality rates associated with emergency surgery, elective surgery, and conservative management.

Summary:

• This study reviewed 34 cases of sigmoid colon volvulus, noting its prevalence in both young and elderly individuals.
• Endoscopic detorsion and intubation, performed when peritoneal signs are absent, proved effective in 87% of cases, successfully averting emergency surgery.
• Emergency surgery carried a high mortality rate (43.5%), while elective surgery after preparation was significantly safer (6.6%).
• Non-surgical management in patients with comorbidities led to frequent complications and a 34% mortality rate.

Impact:

• Endoscopic detorsion followed by a short preparation period for surgical resection offers the best therapeutic success and improved patient survival.
• Minimally invasive endoscopic detorsion can significantly reduce the need for emergent surgical intervention and associated morbidity.
• Optimal management strategies are crucial for improving outcomes in sigmoid colon volvulus patients, especially those with comorbidities.