Abstract
[Purpose & Method] Sigmoid volvulus (SV), that may cause intestinal perforation due to obstruction or impaired blood flow, is classified as a case of acute abdomen. The treatment strategy for SV has not been established. Our strategy was as follows. If both muscle guarding and a deteriorated general condition were observed, or if endoscopy resulted in unsuccessful decompression or showed mucosal necrosis, an emergency operation was performed. The others underwent elective surgery. Hartmann's operation was essentially applied in the emergency surgery and sigmoidectomy in the elective surgery patients. To verify the validity of our strategy, 35 patients who underwent surgery for SV were investigated retrospectively. [Results] The mean age was 76 years and male/female ratio was 29/6. Mortality was zero. Patients in the emergency operation group (n=10) showed a significantly longer postoperative hospital stay than those in the elective surgery group (n=25). [Conclusions] The SV patients whose general condition is good are potential candidates for endoscopic decompression and subsequent elective surgery.
