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Sigmoid volvulus in elderly patients.

M P Bak, S J Boley

American Journal of Surgery

|January 1, 1986

Summary

This summary is machine-generated.

Elderly patients with sigmoid volvulus benefit from early elective resection after nonoperative reduction. This approach maximizes survival, as age alone should not preclude definitive treatment for this condition.

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Area of Science:

Gastroenterology
Colorectal Surgery
Geriatric Medicine

Background:

Sigmoid volvulus is a common cause of bowel obstruction in the elderly.
Nonoperative management is frequently attempted but recurrence rates are high.

Purpose of the Study:

To evaluate the outcomes of nonoperative versus operative management of sigmoid volvulus in patients over 65.
To determine the optimal treatment strategy for maximizing survival in this demographic.

Main Methods:

Retrospective review of 51 patients over 65 admitted for initial sigmoid volvulus.
Analysis of outcomes including reduction success rates, recurrence, and mortality.
Comparison of mortality rates between nonoperative observation, emergency surgery, and elective resection.

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Main Results:

Nonoperative reduction was successful in 91% of initial cases.
Recurrence occurred in 70% of patients managed nonoperatively, with a 21% mortality rate.
Elective resection had a significantly lower mortality rate (5.6%) compared to emergency operations (36%).

Conclusions:

Early elective resection after successful nonoperative reduction of sigmoid volvulus in elderly patients maximizes survival.
Age should not be the sole determining factor for choosing nonoperative management.
Definitive surgical treatment offers better long-term outcomes and reduced mortality.