title: Sigmoid volvulus in the elderly: outcomes of a 43-year, 453-patient experience.
abstract: OBJECTIVE
  The present study reviewed the clinical outcomes of 453 elderly patients with sigmoid volvulus (SV).
  
  
  METHODS
  The clinical records were reviewed retrospectively.
  
  
  RESULTS
  The mean patient age was 71.1 years of age, and 371 patients (81.9%) were male. Of the patients, 30.7% had recurrent volvulus, 34.6% had associated disease, and 16.5% suffered from shock. The correct diagnosis rate based on the clinical features was 66.4%. Radiography revealed SV findings in 64.9% of the patients. Computed tomography (CT) or magnetic resonance imaging (MRI) were diagnostic in all cases. Nonoperative detorsion was performed in 323 patients (71.3%) with 77.4% success, 1.2% mortality, 4.0% morbidity, and 4.4% early recurrence rates. Emergency surgery was required in 215 patients (47.5%) and resulted in 24.2% mortality, 41.4% morbidity, 0.9% early recurrence, and 8.1% late recurrence rates.
  
  
  CONCLUSIONS
  Elderly SV patients generally present with high percentages of recurrent volvulus, serious comorbidity, late admission, and shock. The clinical features may be less diagnostic. Radiological studies, particularly CT or MRI, may assist in an SV diagnosis. Nonoperative detorsion is advocated as the primary treatment. In emergency surgery, nonresectional or nonanastomotic procedures are preferred. The overall patient prognosis is grave, and the disease tends to recur.
authors: Department of General Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey.
authors: S Selcuk
authors: SS
authors: Atamanalp
authors: Gurkan
authors: G
authors: Ozturk
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012769:Shock / Q000175:diagnosis / Q000401:mortality; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome