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Spontaneous decompression of sigmoid volvulus.

Nurhak Aksungur1, Rifat Peksoz2, Esra Disci3

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Pakistan Journal of Medical Sciences
|November 8, 2023
PubMed
Summary

Spontaneous decompression of sigmoid volvulus (SV) is rare, with similar symptoms to SV requiring intervention. Recurrence is common, necessitating procedures to prevent it.

Keywords:
DecompressionSigmoid volvulusSpontaneous

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Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Abdominal Surgery

Background:

  • Sigmoid volvulus (SV) is a common cause of large bowel obstruction, particularly in elderly, institutionalized populations.
  • Spontaneous decompression is an uncommon but recognized outcome of sigmoid volvulus.
  • Understanding the characteristics and management of spontaneously decompressed SV is crucial for patient care.

Purpose of the Study:

  • To evaluate the clinical presentation, diagnosis, treatment, and follow-up of patients with spontaneously decompressed sigmoid volvulus.
  • To compare the incidence and characteristics of spontaneous decompression in a large monocenter series versus worldwide literature.
  • To clarify the optimal management strategy for spontaneously decompressed sigmoid volvulus.

Main Methods:

  • Retrospective analysis of 1,063 sigmoid volvulus patients from a single center.
  • Systematic literature review of Web of Science and PubMed databases over 56 years for spontaneous decompression cases.
  • Comparison of clinical features, treatment, and outcomes between spontaneously decompressed and intervention-required SV.

Main Results:

  • The incidence of spontaneous decompression was 0.1% in the monocenter series and 1.5% in worldwide data, with a cumulative rate of 0.6%.
  • Clinical presentation (abdominal pain, distention, obstipation) of spontaneously decompressed SV is similar to SV requiring intervention.
  • The treatment and follow-up algorithm for spontaneous decompression remains undefined, with a noted tendency for recurrence.

Conclusions:

  • Spontaneous decompression of sigmoid volvulus is a rare event with clinical features mimicking SV requiring intervention.
  • Despite spontaneous decompression, sigmoid volvulus has a tendency to recur, suggesting the need for recurrence-reducing procedures in selected patients.
  • Further research is needed to establish definitive treatment and follow-up guidelines for spontaneously decompressed sigmoid volvulus.