Background. Sigmoid volvulus is an uncommon cause of intestinal obstruction representing the 5% of all Western cases, associated with old age and a history of neurological and psychiatric condition. Generally, its diagnosis is established by clinical and radiologic findings. It often represents an emergency and it is commonly associated with pain, vomit and abdominal tenderness. Case presentation. We present a case of a 59 years old man, admitted to our emergency department, showing an abdominal X-Ray reporting a distention of large bowel,which was required due to presence of multiple diarrhea episodes during the previous 7 days. He had no significant past medical history and did not report constipation or subocclusive episode. Conclusions. Volvulus should be considered in the differential diagnosis in adult and healthy patients with bowel obstructions. Surgery is, in all cases, the radical and definitive treatment since there is a higher mortality in case of recurrent volvulus. Despite the massive bowel distention, our choice was the elective open surgery. Primary anastomosis is feasible and safe and did not lead to any complications. In case of unsuccessful colonic decompression, evidence to support or refute the safety and effectiveness of laparoscopic surgical resection for treatment of patients with sigmoid volvulus disease is not yet proven.

Elective treatment of large-bowel obstruction in asymptomatic sigmoid volvulus / Assenza, M.; Ciccarone, F.; Iannone, I.; Bracchetti, G.; de Meis, E.; Santillo, S.; Ballanti Storace, C.; Mazzarella, G.; de Cicco, M. L.. - In: LA CLINICA TERAPEUTICA. - ISSN 0009-9074. - 171:6(2020), pp. 466-470. [10.7417/CT.2020.2258]

Elective treatment of large-bowel obstruction in asymptomatic sigmoid volvulus

Assenza M.
;
Ciccarone F.;Iannone I.;Bracchetti G.;de Meis E.
;
Santillo S.;Ballanti Storace C.;Mazzarella G.;de Cicco M. L.
2020

Abstract

Background. Sigmoid volvulus is an uncommon cause of intestinal obstruction representing the 5% of all Western cases, associated with old age and a history of neurological and psychiatric condition. Generally, its diagnosis is established by clinical and radiologic findings. It often represents an emergency and it is commonly associated with pain, vomit and abdominal tenderness. Case presentation. We present a case of a 59 years old man, admitted to our emergency department, showing an abdominal X-Ray reporting a distention of large bowel,which was required due to presence of multiple diarrhea episodes during the previous 7 days. He had no significant past medical history and did not report constipation or subocclusive episode. Conclusions. Volvulus should be considered in the differential diagnosis in adult and healthy patients with bowel obstructions. Surgery is, in all cases, the radical and definitive treatment since there is a higher mortality in case of recurrent volvulus. Despite the massive bowel distention, our choice was the elective open surgery. Primary anastomosis is feasible and safe and did not lead to any complications. In case of unsuccessful colonic decompression, evidence to support or refute the safety and effectiveness of laparoscopic surgical resection for treatment of patients with sigmoid volvulus disease is not yet proven.
2020
asymptomatic volvulus; large-bowel obstruction; sigmoid volvulus; uncomplicated volvulus; abdominal pain; decompression, surgical; diagnosis, differential; elective surgical procedures; emergency service, hospital; humans; intestinal obstruction; intestinal volvulus; laparoscopy; male; middle aged; sigmoid diseases
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Elective treatment of large-bowel obstruction in asymptomatic sigmoid volvulus / Assenza, M.; Ciccarone, F.; Iannone, I.; Bracchetti, G.; de Meis, E.; Santillo, S.; Ballanti Storace, C.; Mazzarella, G.; de Cicco, M. L.. - In: LA CLINICA TERAPEUTICA. - ISSN 0009-9074. - 171:6(2020), pp. 466-470. [10.7417/CT.2020.2258]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1639225
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