Effectiveness and clinical results of endoscopic management of sigmoid volvulus using unsedated water-immersion colonoscopy

Shinya Sugimoto, Naoki Hosoe, Takeshi Mizukami, Yuya Tsunoda, Tsuyoshi Ito, Satoshi Imamura, Toshihide Tamura, Shuichi Nagakubo, Yuichi Morohoshi, Yuji Koike, Yuriko Fujita, Hirokazu Komatsu, Haruhiko Ogata, Takanori Kanai

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background and Aim 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. Methods 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. Results 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. Conclusions 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.

Original languageEnglish
Pages (from-to)564-568
Number of pages5
JournalDigestive Endoscopy
Volume26
Issue number4
DOIs
Publication statusPublished - 2014 Jul

Keywords

  • endoscopic detorsion
  • intestinal obstruction
  • recurrence
  • sigmoid volvulus
  • water immersion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Sugimoto, S., Hosoe, N., Mizukami, T., Tsunoda, Y., Ito, T., Imamura, S., Tamura, T., Nagakubo, S., Morohoshi, Y., Koike, Y., Fujita, Y., Komatsu, H., Ogata, H., & Kanai, T. (2014). Effectiveness and clinical results of endoscopic management of sigmoid volvulus using unsedated water-immersion colonoscopy. Digestive Endoscopy, 26(4), 564-568. https://doi.org/10.1111/den.12235