Volvulus of the colon

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Twenty-three instances of colonic volvulus are reported; eighteen were of the sigmoid and five of the cecum. The clinical findings and plain roentgenograms of the abdomen are usually adequate to make the diagnosis. However, barium enema examination should be liberally used unless gangrenous bowel is suspected to exist. Cecal volvulus is treated by operative detorsion and cecostomy. Nonoperative detorsion of sigmoid volvulus is the initial treatment followed by elective resection of the sigmoid to prevent recurrent volvulus. If the bowel is gangrenous, resection in either type of volvulus is mandatory. There were no deaths in the five patients with cecal volvulus, and only two deaths in patients with volvulus of the sigmoid. The mortality for sigmoid volvulus was 11.1 per cent and the over-all mortality for colonic volvulus was 8.7 per cent.