Endoscopic decompression of sigmoid volvulus using a corrugated tube

Sigmoid volvulus is a major cause of large-bowel obstruction in "volvulus belt" countries, where it accounts for up to 50% of cases. Flexible endoscopic detorsion is the first-line therapy for stable patients; however, recurrence rates may reach 75%. Placement of a rectal decompression tube reduces early recurrence and facilitates elective surgery. In many low-resource settings, commercial tubes are unavailable. This video demonstrates the safe, low-cost use of rectal anesthesia corrugated tubes as a practical alternative.

We present the case of a 74-year-old woman exhibiting clinical and radiographic signs of sigmoid volvulus. After flexible endoscopic detorsion, a rectal anesthesia corrugated tube was placed. This video illustrates the step-by-step technique, focusing on technical details, potential pitfalls, and troubleshooting tips.

The patient underwent successful decompression. Radiographic control showed the resolution of the volvulus and correct placement of the tube. The tube stayed in place until the elective laparoscopic sigmoidectomy on day 6. The patient had an uneventful recovery, leading to her discharge on postoperative day 10.

Endoscopic decompression combined with the placement of a rectal anesthesia corrugated tube represents a feasible and practical bridge to surgery. This educational video serves as a valuable resource for training endoscopists, particularly in settings with limited resources.