Abstract
1. 1. A series of forty patients with seventy-one admissions for acute sigmoid volvulus was described. A total of 116 episodes were treated. 2. 2. Nonoperative decompression with a sigmoidoscope and a rectal tube was successful in eighty-two episodes of acute sigmoid volvulus in ninety-eight attempts with only one death which was apparently unrelated to the procedure. In no instance did failure of this treatment appear to complicate the subsequent operative treatment performed. Mortality from operative detorsion was 30 per cent; in primary resection, it was 50 per cent. 3. 3. An analysis of the recurrence rate reveals that 60 per cent of patients had two or more episodes of acute sigmoid volvulus which required treatment. This suggests that definitive resection of the redundant colon should be the ultimate goal of therapy. 4. 4. A rational treatment based on nonoperative decompression of the acute, nonstrangulated episode of sigmoid volvulus is discussed.
Published Version
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