Year 2003 / Volume 95 / Number 8
Original
Indication and results of endoscopic management of sigmoid volvulus

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D. Martínez Ares, J. Yáñez López, J. Souto Ruzo, M.ª A. Vázquez Millán, B. González Conde, F. Suárez López, P. Alonso Aguirre y J. L. Vázquez Iglesias

Abstract
Introduction: sigmoid volvulus is a relatively common cause of intestinal obstruction, particularly in the elderly and in patients
with debilitating conditions. As the risks associated with surgical treatment of the sigmoid volvulus are in many cases too high, conservative (endoscopic) management is an option to be considered.

Material and methods: all emergency lower gastrointestinal endoscopies performed between January 1, 1996 and December 31, 2001 were reviewed and, among these, the cases
of diagnosis of the endoscopic management, percentage of recurrence, mortality rate, complications, surgical procedures etc were evaluated in the selected cases.

Results: lower gastrointestinal endoscopy was diagnostic in all cases. Endoscopic management showed an overall efficacy of 87.5%. Recurrence appeared in approximately 57% of the cases. Successful treatment was accomplished for the first episode in 25% of the cases. In case of recurrence, endoscopic management could be performed again with similar efficacy and safety.

Conclusions: endoscopic reduction is a safe and successful technique for the management of emergency sigmoid volvulus, provided vascular compromise in the intestinal wall is ruled
out. As recurrence is frequent, elective definitive surgery could be a treatment to consider. Endoscopic management could be the only choice treatment in the case of patients not fit for surgery due to the very important risks associated with it in their cases.
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D. Martínez Ares, J. Yáñez López, J. Souto Ruzo, M.ª A. Vázquez Millán, B. González Conde, F. Suárez López, P. Alonso Aguirre y J. L. Vázquez Iglesias. Indication and results of endoscopic management of sigmoid volvulus. 0


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