ENDOSCOPIC TREATMENT FOR SIGMOID VOLVULUS: SINGLE-CENTER RETROSPECTIVE ANALYSIS

Aims Sigmoid volvulus is one of the most common causes of colonic obstruction, caused by the rotation of the sigmoid colon around its meso axis. Diagnosis is based on clinical and radiological elements, either by X-rays or computed tomography (CT). First-line emergency therapy relies on endoscopic treatment (ET) of the volvulus, consisting in the detorsion of the affected loop, associated with colonic decompression.

Methods Retrospective cohort study from a single center, including patients submitted to ET of sigmoid volvulus, between January 2012 and November 2019. Primary success of ET, recurrences and need for surgery were analysed.

Results Included 32 patients, with mean age of 75.8 years (range 21–96). All patients presented with abdominal pain and distension. Initial ET treatment was successful in all patients, without adverse events associated to the procedure. However, recurrence occurred in 17 patients (53.1%), on average after 2.1 days. Concerning recurrences, repeat ET alone was successful in 7 patients. Surgical treatment was performed in 8 cases, with 4 patients requiring emergency surgery. Two patients had significant comorbidities and died before any attempt of retreatment.

Conclusions ET of sigmoid volvulus, although associated with high recurrence rate, is a safe and effective procedure for immediate treatment of a serious clinical condition.