Spontaneous decompression of sigmoid volvulus

Abstract

Objectives: Spontaneous decompression is an uncommon outcome of sigmoid volvulus (SV). The aim of this study was to evaluate the clinical presentation, diagnosis, treatment, and follow-up of spontaneously decompressed SV.

Methods: We utilized the data of our 1,063 SV patients, the most comprehensive monocenter SV series in the world. To obtain the worldwide data on the spontaneous decompression of SV, we researched the last 56-years' literature in Web of Science and PubMed databases.

Results: The incidence of the spontaneous decompression was 0.1% (1/1,063) in our SV series, whereas it was 1.5% (8/549) in the worldwide data (Fisher exact test, p = 0.001). By this way, cumulative spontaneous decompression rate was found as 0.6% (9/1,602). In the spontaneously decompressed cases, the main clinical features were abdominal pain/tenderness, distention, and obstipation, which were similar to management-required patients. However, the treatment and follow-up algorithm is still a relatively undefined subject.

Conclusion: Spontaneous decompression of SV is a very rare clinical entity. The clinical presentation and diagnosis of the spontaneously decompressed SV look alike the management-required SV. However, as seen in most management-required patients, SV tends to recur in the spontaneously decompressed cases and a recurrence-reducing procedure is required in selected patients.

Keywords: Decompression; Sigmoid volvulus; Spontaneous.

Fig.1

a) Abdominal X-ray radiography image (S: Dilated sigmoid colon) b) Axial abdominal computerized tomography image (S: Dilated sigmoid colon, W: Mesenteric whirl sign) c) Control abdominal X-ray radiography image.