A CASE OF NONOPERATIVE REDUCTION OF VOLVULUS OF THE SIGMOID COLON BY MEANS OF A COLONOFIBERSCOPE

Abstract

Sigmoid volvulus has often been treated by operative procedures. More recently, however, there has been an increasing number of case reports in which nonoperative reposition has been successfully conducted through the use of an endoscope, especially the colon fiberscope. In this report we present one case of sigmoid volvulus in which nonoperative reposition was achieved using a colon fiberscope. In Japan, to our knowledge, nine studies have so far described endoscopic reposition for this disturbance, including 21 cases in all. This paper presents a discussion of some of those cases for which a detailed description is available together with our case. Compared to four patients who received emergency operation for this disturbance in our clinic, there was no difference with regard to age or duration of affliction; however, the leucocyte count at the time of presentation tended to be higher in the operated group. In addition to evidence of intestinal necrosis and peritoneal irritation, this seems to suggest that evidence of inflammatory signs such as an increased leucocyte count may be helpful in deciding whether to apply nonoperative reposition.