[Colonoscopic approach in the therapy of sigmoid volvulus].
We present 13 patients with 15 episodes of colonic volvulus, who underwent colonoscopy to decompress and/or devolvulate. Colonoscopic exploration demonstrated a non obstructive dilatation in three cases. In the remaining 10 patients, with 12 episodes of volvulus, decompression was obtained in 83.3% and devoluvulation in 41.6%. There were two failures, due to peritoneal metastases and adhesions which fixed the volvulus. In 40% of the cases there were mild ischemic signs. Forty per cent of the patients were submitted to elective surgery and the two failures (20%) were operated in emergency. The remaining 4 patients declined surgical treatment. At is allows differential diagnosis, we think that, for these patients, colonoscopy should be the first therapeutic approach; it also allows decompression and/or devolvulation and an early diagnosis of the associated ischemia.
Clemente Ricote
G
G
Servicio Medicina Aparato Digestivo, Hospital General Gregorio Marañón, Madrid.
Bañares Cañizares
R
R
Sebastián Domingo
J J
JJ
Rábago Torre
L
L
Menchén
P L
PL
Senent
C
C
Velo
J L
JL
Pérez de Ayala
V
V
Castellanos
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000175:diagnosis / Q000628:therapy*; D003113:Colonoscopy; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000628:therapy*
Abordaje colonscópico en el tratamiento del vólvulo sigmoide.