대한대장항문학회

Purpose : The intestinal volvulus is difficult to diagnose, and if the treatment and diagnosis<br>are delayed, there is a risk of high mortality. This study was performed to ensure the more<br>proper management method and diagnostic modality of volvulus. Methods : Between 1985 and<br>1998, 16 patients with a diagnosis of colonic and small intestinal volvulus were managed in<br>Soonchunhyang University Chunan Hospital. Medical charts were reviewed, retrospectively<br>and follow-up was done. Results : 15 among the 16 patients with volvulus underwent the<br>operation. The one case was diagnosed and expired before operation. The resection of the<br>lesion and primary anastomosis had been generally selected as the procedure of choice.<br>Segmental resection of the sigmoid colon with primary anastomosis was performed on 7<br>cases of the sigmoid volvulus. There were 6 cases of the small bowel volvulus, of which 5<br>cases got a segmental resection of the small bowel with primary repair and the one got a<br>total resection of the small bowel with gastrocolostomy. The right hemicolectomy was<br>performed in 2 cases which were the right colon volvulus. 9 cases of morbidity were<br>developed; there were 5 cases of wound infection and others were enterocutaneous fistula,<br>pulmonary infection, and septic shock respectively. There were three mortality. Conclusion : If<br>the small bowel volvulus is present or gangrenous signs are developed, and the management<br>of the intestinal volvulus is delayed, there can be serious complications and the course can be<br>life-threatening. Therefore, if gangrene or small bowel volvulus are suspected, operative<br>management should be seriously considered.<br>