Operative therapy for sigmoid volvulus
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
The medical records of 54 patients treated for sigmoid volvulus from 1983 to 1987 were reviewed. Patient demographics were very similar to previously published results. Four patients (7.4 percent) underwent emergency resection for gangrene with a mortality of 75 percent. Of the 50 patients who presented without ischemia, 23 (46 percent) were managed by nonoperative detorsion while 3 (6 percent) detorsed spontaneously. Fourteen of these 26 patients received no further treatment. Nonoperative mortality was 0 percent. Celiotomy was performed on 36 patients. The type of operative procedure performed had no significant bearing on outcome. Fifteen patients underwent resection and anastomosis; two of these patients died (13 percent). Fifteen patients underwent resection and colostomy with two deaths (13 percent), and six had open detorsion alone with one death (17 percent). The two factors associated with adverse outcome after surgical intervention were patient age and history of previous volvulus. All five deaths occurred in patients older than 70 years presenting with a first episode of volvulus (N=15, mortality=33 percent). No deaths occurred among patients younger than 70 years regardless of volvulus history or among those older than 70 years who were being treated for a recurrence ( P ≤0.01). Patients older than 70 years with a first episode of volvulus represent a high risk if subjected to surgical intervention. Nonoperative detorsion alone should be considered for this subgroup of patients.
- Arnold GJ, Nance FC. Volvulus of the sigmoid colon. Ann Surg 1973;177:527–33.
- Bak MP, Boley SJ. Sigmoid volvulus in elderly patients. Am J Surg 1986;151:71–5.
- Ballantyne GH. Review of sigmoid volvulus: history and results of treatment. Dis Colon Rectum 25;1982:494–501.
- Bruusgaard C. Volvulus of the sigmoid colon and its treatment. Surgery 1947;22:466–78.
- Drapanas T, Stewart JD. Acute sigmoid volvulus: concept in surgical treatment. Am J Surg 1961;101:70–7.
- Hines JR, Geurkink RE, Bass RT. Recurrence and mortality rates in sigmoid volvulus. Surg Gynecol Obstet 1967:124:567–70.
- Operative therapy for sigmoid volvulus
Diseases of the Colon & Rectum
Volume 33, Issue 8 , pp 643-646
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Sigmoid volvulus
- Risk factors
- Industry Sectors