Volvulus of the colon--a continuing surgical problem.

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Twenty-six cases of colonic volvulus from the University of Kentucky Medical Center and the Lexington Veterans Administration Hospital, covering a ten-year period, are presented. Overall mortality was 19 per cent (5 of 26 patients). Cecal volvulus carried the greatest mortality, 30 per cent (3 of 10 patients), whereas sigmoidal volvulus had relatively low mortality rate of 7 per cent (1 or 15). A single patient who had volvulus of the transverse colon died. The most significant factor leading to death was not necrotic bowel but the necessity for emergency operation in these generally debilitated patients. A plan of management with the major aim to convert emergency situations into elective or urgent ones is presented with the expectation that the mortality rate can be improved.