Strangulated volvulus of the sigmoid colon with inviable mucosal appearance in a non-surgical patient. Endoscopic devolvulation.
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.
Medicine Digestive Service, Hospital Xeral de Lugo, Spain.
A
A
González Ramírez
L
L
López-Rosés
A
A
Lancho Seco
E
E
Santos Blanco
S
S
Soto
B
B
Urraca
S
S
Avila
M J
MJ
García Pais
D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011860:Radiography, Abdominal; D012810:Sigmoid Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D013997:Time Factors