Effectiveness and clinical results of endoscopic management of sigmoid volvulus using unsedated water‐immersion colonoscopy. Issue 4 (17th February 2014)

• Record Type: Journal Article
• Authors: Sugimoto, Shinya; Hosoe, Naoki; Mizukami, Takeshi; Tsunoda, Yuya; Ito, Tsuyoshi; Imamura, Satoshi; Tamura, Toshihide; Nagakubo, Shuichi; Morohoshi, Yuichi; Koike, Yuji; Fujita, Yuriko; Komatsu, Hirokazu; Ogata, Haruhiko; Kanai, Takanori
• Is Part Of: Digestive endoscopy. Volume 26:Issue 4(2014:Jul.)
• Page Start: 564
• Page End: 568
• Publication Date: 2014-02-17
• Subjects: Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12235
• Languages: English
• ISSNs: 0915-5635

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="den12235-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Although intestinal obstruction as a result of sigmoid volvulus (SV) may be successfully resolved using endoscopic detorsion, surgical treatment remains the main therapeutic strategy. We evaluated the endoscopic detorsion procedure using unsedated water‐immersion colonoscopy for the treatment of SV.</p> </sec> <sec id="den12235-sec-0002" sec-type="section"> <title>Methods</title> <p>A retrospective chart review was conducted on the clinical background and prognosis of 21 SV patients who underwent 71 endoscopic detorsion procedures using unsedated, water‐immersion colonoscopy.</p> </sec> <sec id="den12235-sec-0003" sec-type="section"> <title>Results</title> <p>In all, 14 (67%) male and seven (33%) female patients, with a mean age of 73 years (range, 54–95 years) were enrolled; 86% were >70 years of age. Among these patients, 90% had a background of key predisposing factors. In the 21 patients, endoscopic detorsion was successfully done using unsedated water‐immersion colonoscopy. SV recurred in 10 patients at a median of 180 days. Endoscopic detorsion for recurrent SV was successfully achieved in all cases, and none of the secondary cases became severe. Only male patients were observed to experience three or more recurrent episodes of SV.</p> </sec> <sec id="den12235-sec-0004" sec-type="section"> <title>Conclusions</title> <p>SV occurred most commonly in elderly patients with a surgical risk. Our experience suggests that conservative endoscopic treatment using unsedated water‐immersion colonoscopy is a safe, reasonable, conservative endoscopic approach for elderly patients in the absence of necrotic findings. We currently use this procedure in most of our cases.</p> </sec> </abstract>