Abstract

ANAYA KIPPES, Mario Edgar. VOLVULO DE SIGMOIDES, INTUBACION RECTO SIGMOIDEA DESCOMPRESIVA. Rev. méd. (Cochabamba) [online]. 2009, vol.20, n.30, pp. 68-75. ISSN 2074-4609.

The author analysis for a period of 15 years the treatment of volvulus of the sigmoid by Rectosigmoid Endoscopic Decompression. The decompression for the necrosis of the twisted loop is done throught the intramural strangulation; described by Ochesner for the obstruction of the bowel and not due to the torsion of the sigmoid (suppossebly strangulating the sigmoids) and this necrosis depends on the increased intraluminal pression, that makes possible endoscopic treatment. The accomplished decompressions in 100 patients, without morbidity confirm this concept. On the other side, according to the selective arteriographies that were done by the authors, due to the urgency of the situation, confirms the fact that even though there are signs of necrosis of the volvulated bowel, the sigmoid arteries are permeability necrosis happens due to intralumural strangulation. Necrosis should be treated with resection of the volvulated bowel by (Hartman procedure). All the patients that submitted Rectosigmoid Endoscopic Decompression should have done the abdominal rectosigmoidectomy (modified Duhamal Haddad) for the acquired chagasic megacolon or left colectomy, for the treatment of the Idiopathic Dolichocolon.

Keywords : Sigmoides: vólvulo fisiopatología; Tratamiento endoscopico.