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Related Experiment Videos

Recurrence of volvulus after sigmoidectomy.

P J Harbrecht, D E Fry

    Diseases of the Colon and Rectum
    |September 1, 1979
    PubMed
    Summary

    Recurrent sigmoid volvulus can occur after sigmoidectomy, especially in patients with chronic megacolon. This suggests sigmoidectomy may be insufficient for certain patient groups, impacting surgical decisions.

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    Area of Science:

    • Gastroenterology
    • Surgical Gastroenterology
    • Colorectal Surgery

    Background:

    • Colonic volvulus, particularly left-sided sigmoid volvulus, is a significant cause of bowel obstruction.
    • Sigmoidectomy is a common surgical approach for managing sigmoid volvulus.
    • Recurrence rates after surgical intervention warrant further investigation.

    Observation:

    • Three patients presented with recurrent left-sided colonic volvulus following sigmoidectomy.
    • All observed patients had a history of chronic, acquired megacolon.
    • Literature review confirmed additional cases of late volvulus recurrence post-sigmoidectomy.

    Findings:

    • Sigmoidectomy may not achieve a 'total resection' in cases of redundant sigmoid loops, leading to recurrence.
    • The presence of chronic acquired megacolon appears to be a risk factor for recurrent sigmoid volvulus.
    • Late recurrences of sigmoid volvulus after sigmoidectomy are documented, indicating potential limitations of the procedure.

    Implications:

    • Sigmoidectomy might be an inadequate surgical procedure for sigmoid volvulus in younger patients or those with severe chronic megacolon.
    • Clinical decisions regarding interval operations and surgical technique selection should consider the risk of recurrence in specific patient populations.
    • Further research into alternative or modified surgical strategies for sigmoid volvulus in at-risk patients is recommended.

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