Diseases of the Colon & Rectum

, Volume 33, Issue 8, pp 643–646 | Cite as

Operative therapy for sigmoid volvulus

Identification of risk factors affecting outcome
  • James B. Peoples
  • John C. McCafferty
  • Kenneth S. Scher
Original Contributions
  • 24 Downloads

Abstract

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.

Key words

Sigmoid volvulus Risk factors 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Arnold GJ, Nance FC. Volvulus of the sigmoid colon. Ann Surg 1973;177:527–33.Google Scholar
  2. 2.
    Bak MP, Boley SJ. Sigmoid volvulus in elderly patients. Am J Surg 1986;151:71–5.Google Scholar
  3. 3.
    Ballantyne GH. Review of sigmoid volvulus: history and results of treatment. Dis Colon Rectum 25;1982:494–501.Google Scholar
  4. 4.
    Bruusgaard C. Volvulus of the sigmoid colon and its treatment. Surgery 1947;22:466–78.Google Scholar
  5. 5.
    Drapanas T, Stewart JD. Acute sigmoid volvulus: concept in surgical treatment. Am J Surg 1961;101:70–7.Google Scholar
  6. 6.
    Hines JR, Geurkink RE, Bass RT. Recurrence and mortality rates in sigmoid volvulus. Surg Gynecol Obstet 1967:124:567–70.Google Scholar

Copyright information

© J. B. Lippincott Co 1990

Authors and Affiliations

  • James B. Peoples
    • 1
  • John C. McCafferty
    • 1
  • Kenneth S. Scher
    • 1
  1. 1.Department of SurgeryWright State University School of MedicineDayton

Personalised recommendations