2018 Volume 60 Issue 11 Pages 2393-2400
A 92-year-old man was hospitalized for recurrent sigmoid colon volvulus. He had suffered six previous episodes of sigmoid colon volvulus in the past nine months. He was deemed unfit for surgery because of severe dementia, and he was treated with endoscopic decompression four times and with endoscopic detorsion two times for the six previous episodes. During the hospital admission for the seventh episode of sigmoid colon volvulus, although endoscopic findings revealed severely ischemic mucosa, the patient recovered after endoscopic decompression was performed. He was treated with percutaneous endoscopic colostomy (PEC) in order to prevent future recurrence of sigmoid colon volvulus. He experienced no procedural complications and had no recurrences of sigmoid colon volvulus in the subsequent three years before his death from other diseases. Because sigmoid colon volvulus often occurs in the elderly and in complex patients, surgery is often associated with high mortality rates. At the same time, conventional endoscopic treatments are associated with high recurrence rates. Our case suggests that PEC is an effective treatment for recurrent sigmoid colon volvulus in high-risk patients.
