WSES consensus guidelines on sigmoid volvulus management

Tian, Brian; Vigutto, Gabriele; Tan, Edward; Goor, Harry van; Bendinelli, Cino; Abu‐Zidan, Fikri M.; Ivatury, Rao R.; Sakakushev, Boris; Carlo, Isidoro Di; Sganga, Gabriele; Maier, Ronald V.; Coimbra, Raúl; Leppäniemi, Ari; Litvin, Andrey; Damaskos, Dimitrios; Broek, Richard ten; Biffl, Walter L.; Saverio, Salomone Di; Simone, Belinda De; Ceresoli, Marco; Picetti, Edoardo; Galante, Joseph M.; Tebala, Giovanni Domenico; Beka, Solomon Gurmu; Bonavina, Luigi; Y, Cui; Khan, Jim; Cicuttin, Enrico; Amico, Francesco; Inaba, Kenji; Hecker, Andreas; Ansaloni, Luca; Sartelli, Massimo; Moore, Ernest E.; Kluger, Yoram; Testini, Mario; Weber, Dieter; Agnoletti, Vanni; Angelis, Nicola De; Coccolini, Federico; Sall, Ibrahima; Catena, Fausto

doi:10.1186/s13017-023-00502-x

Cited by 40 publications

(44 citation statements)

References 84 publications

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“…If there is suspicion for ischemia or perforation, computed tomography (CT) scan with or without rectal contrast may provide additional information and confirm diagnosis. 4 CT scans have 100% sensitivity and greater than 90% specificity for sigmoid volvulus. 8 Common findings include a mesenteric swirl.…”

Section: Diagnosismentioning

confidence: 99%

“…Given the frequency of presentation, there are several high-quality clinical practice guidelines including those from the American Society of Colon and Rectal Surgeons and the World Society of Emergency Surgery. 1,4 Presentation Patients presenting with sigmoid volvulus may have nonspecific symptoms including abdominal pain, bloating, cramping, nausea, emesis, and obstipation. Depending on cognitive status at baseline, obtaining an accurate history may be difficult.…”

Section: Epidemiologymentioning

confidence: 99%

“…After entering the abdomen, colonic detorsion should not be performed prior to resection to prevent release of endotoxin, which can lead to clinical decompensation. 4 Only the involved segment of the sigmoid colon needs to be resected. Typically, this does not require mobilization or resection of the rectum.…”

Section: Managementmentioning

confidence: 99%

“…1 If there is evidence of ischemia, emergent surgery is indicated. However, if the mucosa appears viable, then endoscopic detorsion is the first-line management for sigmoid volvulus 1,4 and is successful in 60 to 95% of cases. 1,9 When successful, a rectal tube should be placed for ongoing colonic decompression and prevention of recurrent torsion.…”

Section: Managementmentioning

confidence: 99%

“…11 For patients with sigmoid volvulus and megacolon secondary to chronic constipation or dysmotility, a subtotal colectomy may be considered to prevent repeat volvulus. 4 When primary anastomosis is performed, this may be in an end-to-end, side-to-side, or side-to-end (Baker) fashion using staplers or handsewn techniques based on surgeon preference and patient anatomy. There are no data to support one anastomotic technique over another.…”

Section: Managementmentioning

confidence: 99%

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Colonic Volvulus

Savitch,

Harbaugh

2023

Clin Colon Rectal Surg

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Colonic volvulus represents 10 to 15% of all large bowel obstructions in the United States. It most commonly occurs in the sigmoid colon or cecum. Morbidity and mortality from colonic volvulus are high. It is therefore essential to have a high level of suspicion based on presentation and expedient diagnosis and management to prevent progression to ischemia or perforation. Broad goals of management include evaluation of colon viability, relief of obstruction, and prevention of recurrence. Endoscopic and surgical approaches vary based on the site of volvulus, presence of ischemia or perforation, and patient characteristics. This review outlines the epidemiology, presentation, diagnosis, and management of colonic volvulus. A contemporary diagnostic and treatment algorithm is included.

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Section: Diagnosismentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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Colonic Volvulus

Savitch,

Harbaugh

2023

Clin Colon Rectal Surg

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Response: Sigmoid volvulus in pregnancy: A rare case report

Pfeiffer,

Clark,

Sullivan

et al. 2024

Intl J Gynecology & Obste

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We have been asked by the Editors of the International Journal of Gynecology & Obstetrics to comment on the preceding rebuttal 1 of our case report on sigmoid volvulus (SV) in pregnancy. 2 Out of several types of large-bowel obstruction, colonic volvulus is less common in the United States and Europe, while it has high prevalence in Indian subcontinent, Africa, and the Middle East. SV accounts for a majority of all the reported cases of colonic volvulus. 3

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Restoration of intestinal continuity following emergency sigmoid colectomy for sigmoid volvulus: An American College of Surgeons National Surgical Quality Improvement Program analysis using coarsened exact matching

Yang,

Ang,

Berney

2024

World j. surg.

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BackgroundThere is limited data to guide decision‐making between performing a primary anastomosis and fashioning an end colostomy following emergency sigmoid colectomy for patients with sigmoid volvulus. The aim of this study was to compare the outcomes of these two approaches.MethodsThe American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP) database from 2006 to 2021 was retrospectively analyzed. Missing data were multiply imputed, and coarsened exact matching was performed to generate matched cohorts. Rates of major complications and other postoperative outcomes were evaluated among patients who had a primary anastomosis as compared with matched controls who had an end colostomy following emergency sigmoid colectomy.ResultsOverall, 4041 patients who had a primary anastomosis and 1240 who had an end colostomy met the inclusion criteria. After multiple imputation and coarsened exact matching, 895 patients who had a primary anastomosis had a matched control. The rate of major complications was lower in patients who had an end colostomy (33.2% vs. 36.7%), but this difference was not statistically significant (OR 0.86, 95% CI 0.70–1.05). Results were similar in subgroup analyses of higher‐risk patients. There were no significant differences in overall complication rate, mortality, length of hospital stay, or readmission rate. Patients with a colostomy were more likely to be discharged to a care facility (OR 1.35, 95% CI 1.09–1.67).ConclusionDifferences in rates of major complications and many other outcomes after primary anastomosis as compared with end colostomy were not statistically significant following emergency sigmoid colectomy for sigmoid volvulus.

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WSES consensus guidelines on sigmoid volvulus management

Cited by 40 publications

References 84 publications

Colonic Volvulus

Colonic Volvulus

Response: Sigmoid volvulus in pregnancy: A rare case report

Restoration of intestinal continuity following emergency sigmoid colectomy for sigmoid volvulus: An American College of Surgeons National Surgical Quality Improvement Program analysis using coarsened exact matching

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