Meroño Carbajosa E A, Menárguez Pina F J, Morales Calderón M, Martín Avila V, Medrano Heredia J
General Surgery Service, University Hospital of San Juan, Alicante, Spain.
Rev Esp Enferm Dig. 1998 Dec;90(12):863-9.
Colonic volvulus affects mainly the geriatric population and is associated with a high number of complications when treated by emergency surgery. The development of alternative methods has replaced and reduced the number of traditional surgical procedures. We present the results of treatment of colonic volvulus in a surgical service in Alicante, Spain. Between 1993 and 1997 a total of 17 cases in 15 patients were diagnosed, 16 in the sigmoid colon and 1 in the cecum. In 9 (60%) patients endoscopic devolvulation was successful. In 2 (22%) of these patients the problem recurred, and was resolved by a second endoscopic treatment. Three patients (20%) required surgery, and 3 others (20%) were treated with radiological reduction (barium enema) and rectal catheter. The average hospital stay of patients treated with endoscopy and barium enema was 2-3 days, being 7 days in patients who underwent surgery. Management with endoscopy is initially effective in most cases of volvulus of the sigmoid colon. This procedure affords decompression and adequate preparation of selected patients for surgical resection, which is the treatment of choice and provides the greatest guarantee against subsequent recurrence.
结肠扭转主要影响老年人群，急诊手术治疗时并发症发生率较高。替代方法的发展已取代并减少了传统外科手术的数量。我们展示了西班牙阿利坎特一家外科服务机构中结肠扭转的治疗结果。1993年至1997年间，共诊断出15例患者中的17例结肠扭转病例，其中16例位于乙状结肠，1例位于盲肠。9例（60%）患者通过内镜下复位成功。其中2例（22%）患者病情复发，经第二次内镜治疗得以解决。3例患者（20%）需要手术治疗，另外3例（20%）接受了放射学复位（钡灌肠）和直肠插管治疗。接受内镜检查和钡灌肠治疗的患者平均住院时间为2 - 3天，接受手术的患者为7天。内镜治疗在大多数乙状结肠扭转病例中最初是有效的。该方法可为减压，并为选定患者进行手术切除提供充分准备，手术切除是首选治疗方法，能最大程度地防止后续复发。
