SIGMOIDOSCOPIC DETORTION IN THE TREATMENT OF ACUTE SIGMOID VOLVULUS
YILMAZ AKGÜN, BİLSEL BAÇ, NEDİM ABAN, ŞÜKRÜ BOYLU, CELALETTİN KELEŞ
Dicle Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, DİYARBAKIR
Abstract
During the 8 year period between 1985-1993, the records of 120 patients with acute volvulus of sigmoid colon treated by sigmoidoscopic detortion were studied retrospectively.
The male/female ratio in our patients was 4.7/1. The mean age was 55 with 92.5% of the cases above 40 years.
The most frequent complaints and physical findings were abdominal pain, constipation, distention, and an empty rectum on digital examination. Tyical sigmoid colon distention in plain abdominal x-rays was the most diagnostic finding in the differantial diagnosis. We were successful in 107 (89.1%) of the 120 cases in whom we attempted sigmoidoscopic detortion. Perforation developed in 5 (4.1%) and detortion couldn't be obtained in 2 (1.6%) patients. Only 44 patients in the group of 107 with successful sigmoidoscopic detortion accepted elective operation.
In the group of 63 patients refusing further treatment 4 patients were readmitted with early and 15 patients with late recurrence. The recurrence rate among those who could reach to us was 30.1 percent.
The mortality rate related to sigmoidoscopic detortion was 1.6% in this study.
The results of the patients with acute volvulus of sigmoid colon showed that the sigmoidoscopic detortion is the first and reliable choice for both diagnosis and treatment.