What is the nonoperative method to decompress a sigmoid volvulus after diagnosis?

What is the nonoperative method to decompress a sigmoid volvulus after diagnosis?

• A. Nasogastric decompression only
• B. Left colectomy with primary anastomosis
• C. Sigmoidoscopy with decompression
• D. Laparotomy with resection

Answer: (C)

Sigmoid volvulus is caused by twisting of the sigmoid colon, which blocks the passage of stool and gas. In a stable patient without signs of ischemia or peritonitis, the preferred nonoperative way to decompress is endoscopic detorsion with sigmoidoscopy. Passing a flexible or rigid sigmoidoscope into the distended sigmoid allows the physician to untwist the loop and suction the accumulated gas and fluid, effectively relieving the obstruction. A rectal tube may be left in place afterward to help reduce immediate recurrence. This approach treats the mechanical twist directly without opening the abdomen, making it the best nonoperative option when feasible. If detorsion fails, if there are signs of ischemia or perforation, or if the patient cannot tolerate nonoperative measures, surgical intervention becomes necessary. Relying on nasogastric decompression alone won’t relieve the twist in the sigmoid colon, so it isn’t the definitive nonoperative method. Surgical options such as left colectomy with primary anastomosis or laparotomy with resection are operative treatments and are used when nonoperative decompression is unsuccessful or contraindicated.

Sigmoid volvulus is caused by twisting of the sigmoid colon, which blocks the passage of stool and gas. In a stable patient without signs of ischemia or peritonitis, the preferred nonoperative way to decompress is endoscopic detorsion with sigmoidoscopy. Passing a flexible or rigid sigmoidoscope into the distended sigmoid allows the physician to untwist the loop and suction the accumulated gas and fluid, effectively relieving the obstruction. A rectal tube may be left in place afterward to help reduce immediate recurrence. This approach treats the mechanical twist directly without opening the abdomen, making it the best nonoperative option when feasible. If detorsion fails, if there are signs of ischemia or perforation, or if the patient cannot tolerate nonoperative measures, surgical intervention becomes necessary.

Relying on nasogastric decompression alone won’t relieve the twist in the sigmoid colon, so it isn’t the definitive nonoperative method. Surgical options such as left colectomy with primary anastomosis or laparotomy with resection are operative treatments and are used when nonoperative decompression is unsuccessful or contraindicated.