Impact of watch and wait procedure after endoscopic detorsion for sigmoid volvulus in high risk dementia patients

Abstract

IntroductionVolvulus is defined as an acute bowel dilatation, which must be treated after the diagnosis in a short time, which otherwise can cause necrosis and perforation of the bowel. Chronic constipation and neurological diseases are the most common causes in some countries. In this study, patients with sigmoid volvulus who were treated and followed up were examined, the association of it with neurological diseases was investigated, and the demographic characteristics of the patients, treatment approaches, and results were presented.Material and methodsPatients who underwent colonic volvulus with dementia between January 2010 and August 2020 were retrospectively reviewed. The demographic characteristics and histopathological diagnosis of the patients were recorded. Differences in treatment modalities and results of patients with volvulus were statistically analyzed.ResultsSeventy-eight patients who had sigmoid volvulus and dementia were included the study. The median age was 82.0 years and males represented 71.8% of the patients. All the patients had abdominal pain, while the other common symptoms were vomiting, abdominal distension and constipation. The complication rate was statistically significantly higher in surgical treatment than endoscopic procedures and spontaneously detorsioned (p = 0.011). The median length of stay was statistically significantly different in the surgery group, endoscopic procedure group and spontaneously detorsioned group (p < 0.001).ConclusionsThe prevalence of volvulus is high in individuals with neurological disease. Successful results were obtained with non-surgical follow-up after endoscopic detorsion in the selected patient group in the results of this study, and mortality and morbidity were at lower rates than surgery.