Volvulus of the sigmoid colon. Therapeutic strategy. About 38 cases

ABSTRACT

A retrospective study of 38 cases of sigmoid volvulus is reported. The relative frequency of this pathology among young people in Morocco is noted. In 82% of cases diagnosis was without difficulty; and in two cases an associated small bowel volvulus was found. When deciding on the therapeutic approach it is essential to differentiate between cases in which the sigmoid colon is necrotic and those in which the changes are reversible. In the latter, the authors recommend a non surgical reduction [using flatus tube or better colonoscopy] with elective surgery performed at later date. If initial reduction proves impossible, colonic resection whith colostomy appears to give the best results: