Percutaneous gas decompression can ease endoscopic derotation in sigmoid volvulus

Abstract

Sigmoid volvulus is a disease of elderly and debilitated patients. In sigmoid volvulus patients, colonoscopic derotation is the most commonly applied approach as the first line treatment. However, colonoscopic derotation sometimes fail and then urgent surgery is required in these frail patients with high morbidity and mortality. Percutaneous colonic gas decompression has been described to sigmoid volvulus. In case of life-threating increase intraabdominal pressure and as a primary attempt before colonoscopy. However, this technique did not find wide acceptance in the literature. Here, we aimed to present a 78-year-old male with sigmoid volvulus in whom colonoscopic derotation failed and following percutaneous gas decompression, endoscopic derotation could be done successfully. Evacuation of percutaneous colon gas in the sigmoid volvulus may facilitate endoscopic derotation when the first colonoscopic attempt failed.