ABSTRACT

Conclusion:

Although endoscopic decompression seems the best therapeutic approache, definitive surgical resection+anastomosis with or without colostomy must be primary option for colonic torsions due to high recurrence rate after the decompressive treatment in the follow-up period.

Results:

Seven cases (%35) died. No complication was seen in the groups. However, in the subgroup of advanced age and gangrenous intestines 2 cases died resulting in 100% mortality rate. Three cases previously treated by detortion developed recurrence and re-operated by resection and primary anastomosis.In the elective surgery arm neither recurrence nor mortality was observed.

Method:

In 10-year period between 1996-2006, retrospective scanning were made and we encountered 20 (19 Sigmoid, 1 ceacum) colonic volvulus. Three cases were treated by surgical decompression, 13 cases were treated by resection and Hartmann colostomy, 1 cases was treated by hemicoloctomy and finally 3 cases were treated by resection and primer anastomosis. The cases were grouped into two groups according to the viability of intestines. In the gangreneus arm 4 cases underwent emergent resection and colostomy construction. In the non-gangreneus arm 3 detorsion procedures, 3 resection and primary anastomosis, 10 resection and Hartmann colostomy were performed.Results were analyzed according to the age, sex, complication, death and local recurrence.

Purpose:

To determinate most available therapeutic approaches for colonic volvulus which causes mechanical bowel obstructions.