Kronborg O, Lauritsen K
Acta Chir Scand. 1975;141(6):550-3.
The results of treatment for volvulus of the colon during 13 years in a community hospital are analysed, It is concluded that sigmoid volvulus should be treated with proctoscopic examination and insertion of a rectal tube, unless signs of gangreana or peritonitis are present. In patients without accompanying sever diseases, elective resection should be performed later. Repeated tube decompressions should be attempted in patients with recurrence and high operative risk. Unsuccessful tube decompressions or signs of a non-viable colon should be followed by emergence laparotomy and, probably, resection of the sigmoid colon whether gangraena is present or not. Volvulus of the cecum should be treated with operative reduction and pexia or cecostomy, unless gangreana necessitating a hemicolectomy is present.
分析了一家社区医院13年来结肠扭转的治疗结果。得出结论:除非存在坏疽或腹膜炎迹象,乙状结肠扭转应通过直肠镜检查和插入肛管进行治疗。对于无伴随严重疾病的患者,后期应进行择期切除。对于复发且手术风险高的患者,应尝试反复进行肛管减压。肛管减压失败或出现结肠无活力迹象后,应紧急剖腹手术,可能需切除乙状结肠,无论是否存在坏疽。盲肠扭转应通过手术复位、固定或盲肠造口术进行治疗,除非存在需要进行半结肠切除术的坏疽。