Volvulus du sigmoïde : diagnostic et traitement en urgence

A 88 year old patient consults to the ED for abdominal pain lasting for three days. Clinical examination found a distended abdomen, weathered, painful on palpation. Transit is preserved with three loose stools per day. The abdominopelvic scan with iodine injection shows a sigmoid volvulus with upstream colonic distension. Endoscopy allows the crossing of the volvulus and untwisting a exsufflation colo and a suction-colic. Immediate change is simple. Volvulus recurrence five days after endoscopy, requiring a new colo exsufflation with untwisting. The patient returns to his home after eleven days of hospitalization, prescription laxatives and enemas daily rectal. The discussion describes the epidemiology, diagnosis, complications and emergency treatment of sigmoid volvulus.