Khoury G A, Pickard R, Knight M
Br J Surg. 1977 Aug;64(8):587-9. doi: 10.1002/bjs.1800640817.
The clinical presentation and treatment of 31 consecutive patients with sigmoid volvulus are reviewed. Nearly half of these patients had a history of mental illness and one-third of all patients were chronically constipated. The main clinical features of abdominal pain and gross abdominal distension had been present for an average of 8 days before presentation of the patient to hospital. The clinical diagnosis of sigmoid volvulus was not difficult but the presence of non-viable bowel was more difficult to establish. A silent abdomen was the most valuable indication of the presence of gangrenous bowel. Conservative measures, including sigmoidoscopy and therapeutic barium enema, successfully reduced the volvulus in half of the cases so treated. In those patients undergoing surgery the procedure associated with the lowest mortality was sigmoid resection with end-to-end anastomosis. The overall mortality was 35%.
回顾了31例连续性乙状结肠扭转患者的临床表现及治疗情况。这些患者中近一半有精神疾病史，所有患者中有三分之一长期便秘。腹痛和明显腹胀的主要临床特征在患者入院前平均已出现8天。乙状结肠扭转的临床诊断并不困难，但确定肠管有无坏死则更难。腹部无肠鸣音是肠坏疽存在的最有价值指征。保守措施，包括乙状结肠镜检查和治疗性钡剂灌肠，在接受治疗的病例中有一半成功解除了扭转。在接受手术的患者中，死亡率最低的手术方式是乙状结肠切除端端吻合术。总体死亡率为35%。
