Starling J R
Ann Surg. 1979 Jul;190(1):36-9. doi: 10.1097/00000658-197907000-00008.
The initial management of acute, nonstrangulated sigmoid volvulous is to attempt proctosigmoidoscopic, rectal tube, or barium enema reduction and evacuation. If unsuccessful emergency surgery is necessary. The flexible colonoscope offers an additional therapeutic modality to effectuate preoperative reduction of the twisted sigmoid colon if attempts with conventional methods fail. Three cases of acute sigmoid volvulous are presented which illustrate for the first time successful reduction of acute sigmoid volvulous by colonoscopy after failure of the usual methods of treatment. Instead of emergency surgery all of these patients had elective resection with primary colocolostomy. Patients with acute sigmoid volvulous refractile to reduction by conventional modalities should have an attempt at flexible colonoscopic reduction.
急性、非绞窄性乙状结肠扭转的初始治疗是尝试通过直肠乙状结肠镜检查、肛管或钡剂灌肠进行复位和排空。如果不成功，则需要进行急诊手术。如果传统方法尝试失败，柔性结肠镜提供了一种额外的治疗方式来实现术前扭转乙状结肠的复位。本文介绍了3例急性乙状结肠扭转病例，首次说明了在常规治疗方法失败后通过结肠镜成功复位急性乙状结肠扭转。这些患者均未进行急诊手术，而是选择了一期结肠结肠造口术的择期切除术。对传统方式复位无效的急性乙状结肠扭转患者应尝试柔性结肠镜复位。
