A CASE OF SIGMOID VOLVULUS DETORSION UPON INSERTION OF A SECOND ENDOSCOPE FOR DEGASIFICATION

Abstract

A 73-year-old man presented at his local clinic with chief complaints of constipation, abdominal pain, and bloating. In the abdominal X-ray, sigmoid volvulus was suspected, and therefore he was referred to our hospital.

The absence of intestinal necrosis and perforation was validated by examination, blood sampling, and imaging findings at our hospital. Therefore, colonoscopic detorsion was chosen as the treatment method. A colonoscope was inserted into the sigmoid colonic loop deeper than the site of strangulation, and degasification was performed. Next, the scope was pushed forward to the descending colon; however, there was a poor visual field because of abundant stool. Hence, insufflation was needed, and with re-accumulation of gas in the sigmoid colonic loop, detorsion was difficult to perform. This required the insertion of a second scope for degasification, and upon performing degasification within the loop, detorsion was achieved. We report a case of sigmoid volvulus that was successfully treated by insertion of a second endoscope.