title: Management of sigmoid volvulus avoiding sigmoid resection.
abstract: Acute sigmoid volvulus is typically caused by an excessively mobile and redundant segment of colon with a stretched mesenteric pedicle. When this segment twists on its pedicle, the result can be obstruction, ischemia and perforation. A healthy, 18-year-old Caucasian woman presented to the emergency department complaining of cramping abdominal pain, distention, constipation and obstipation for the last 72 h, accompanied by nausea, vomiting and abdominal tenderness. The patient had tympanitic percussion tones and no bowel sounds. She was diagnosed with acute sigmoid volvulus. Although urgent resective surgery seems to be the appropriate treatment for those who present with acute abdominal pain, intestinal perforation or ischemic necrosis of the intestinal mucosa, the first therapeutic choice for clinically stable patients in good general condition is considered, by many institutions, to be endoscopic decompression. Controversy exists on the decision of the time, the type of definitive treatment, the strategy and the most appropriate surgical technique, especially for teenagers for whom sigmoid resection can be avoided.
authors: Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis.
authors: Nikolaos
authors: N
authors: Katsikogiannis
authors: Nikolaos
authors: N
authors: Machairiotis
authors: Paul
authors: P
authors: Zarogoulidis
authors: Eirini
authors: E
authors: Sarika
authors: Aikaterini
authors: A
authors: Stylianaki
authors: Maria
authors: M
authors: Zisoglou
authors: Vasilis
authors: V
authors: Zervas
authors: Metaxia
authors: M
authors: Bareka
authors: Christos
authors: C
authors: Christofis
authors: Alkis
authors: A
authors: Iordanidis