Endoscopic reduction of sigmoid colon volvulus

Aims Sigmoid colon volvulus requires endoscopic treatment to relieve the torsion and degas the colon. We will examine cases in which torsion release was unsuccessful and search for useful indicators for future treatment.

Methods We examined 52 cases and 34 patients who underwent endoscopic reduction at our hospital from April 2014 to October 2024. Group A consisted of 9 cases of unsuccessful detorsion, and Group B consisted of 43 cases of successful detorsion. Clinical data between the two groups was examined in a retrospective observational study.

Results Male/female, group A 5/4, group B 20/23. The average age was group A 81.0 years, group B 76.2 years. The mean WBC of blood samples was 11173/μl in group A and 7285/μl in group B (p=0.0082). CRP averaged 4.17mg/dl in group A and 3.17mg/dl in group B. Lactate averaged 2.8mmol/l in group A and 1.5mmol/l in group B. Peritoneal irritation symptoms were observed in 8 cases (88.9%) in group A and 9 cases (20.9%) in group B (p<0.0001). 5 cases (55.6%) of group A and 1 case (2.3%) of group B had shock (p<0.0001). The causes of failure in detorsion were intestinal necrosis in 6 cases and intestinal overlength in 3 cases. Survival was 6 cases (66.7%) in group A and 43 cases (100%) in group B (p<0.0001).

Conclusions If the patient has peritoneal irritation or a state of shock, surgical treatment must be considered as a case in which the torsion cannot be released.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025