Intest Res  
Clinical outcomes of sigmoid colon volvulus: identification of the factors associated with successful endoscopic detorsion
Tomoya Iida1, Suguru Nakagaki1, Shuji Satoh1, Haruo Shimizu1, Hiroyuki Kaneto1, Hiroshi Nakase2
1Department of Gastroenterology, Muroran City General Hospital, Muroran, and 2Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
Correspondence to: Hiroshi Nakase, Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo 060-8556, Japan. Tel: +81-11-611-2111, Fax: +81-11-611-2282, E-mail: hiropynakase@gmail.com
Received: September 14, 2016; Revised: October 27, 2016; Accepted: October 28, 2016; Published online: April 5, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Although multiple treatment options exist for the management of sigmoid colon volvulus, no study has examined the factors associated with successful endoscopic detorsion. This the study aimed to examine the clinical course of patients with sigmoid colon volvulus and to identify factors related to successful endoscopic detorsion. Methods: This study included 30 cases (21 patients) of sigmoid volvulus from among 545 cases of intestinal obstruction at a single center. We retrospectively examined the clinical course and the factors associated with the possibility of endoscopic detorsion of sigmoid colon volvulus. Results: The rate of laxative use among the study participants was 76.2%; the rate of comorbid neuropsychiatric disorders was 61.9%; and 57.1% of patients had a history of open abdominal surgery. All patients were initially treated with endoscopic detorsion, and this procedure had a 61.9% success rate. The recurrence rate after detorsion was as high as 46.2%, but detorsion during revision endoscopy was possible in all cases. Statistical analysis revealed that the absence of abdominal tenderness (P =0.027), the use of laxatives (P =0.027), and a history of open abdominal surgery (P =0.032) were factors predictive of successful endoscopic detorsion. Conclusions: The results of our study are consistent with previous reports with respect to the success rate of endoscopic detorsion, the subsequent recurrence rate, and the proportion of patients requiring surgical treatment. In addition, we identified the absence of abdominal tenderness, the use of laxatives, and history of open abdominal surgery as factors predicting successful endoscopic detorsion of sigmoid colon volvulus.
Keywords: Intestinal volvulus; Intestinal obstruction; Colonoscopy; Sigmoidoscopy


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