Strangulated volvulus of the sigmoid colon with inviable mucosal appearance in a non-surgical patient. Endoscopic devolvulation
González Ramírez, A.; López-Rosés, L.; Lancho Seco, A.; Santos Blanco, E.; Soto, S.; Urraca, B.; Avila, S.; García Pais, M.J.
Revista Espanola de Enfermedades Digestivas Organo Oficial de la Sociedad Espanola de Patologia Digestiva 94(4): 221-225
2002
ISSN/ISBN: 1130-0108 PMID: 12185933 Document Number: 546639
Colonoscopy is presently always performed before surgical management of a volvulus in the sigmoid colon. It leads to know the viability of the mucosa and, when possible, to resolve the volvulus conservatively. Besides, with endoscopic control, we can place a decompression tube proximal to the volvulated sigmoid colon, favouring a non-surgical resolution. With this conservative approach it is possible to overcome the acute period, and to restore the viability of the sigmoid wall, waiting for a definitive surgical management with less morbidity and mortality. Only with endoscopy, revolvulation does occur in 35-50% of cases. We present the clinical case of a sigmoid volvulus with compromised sigmoid wall in an 82-year-old man with several clinical problems contraindicating surgery. Endoscopic devolvulation with tube placement was adequate to resolve this sigmoid volvulus.