Treating Sigmoid Volvulus in the Presence of Concomitant Megacolon

When sigmoid volvulus occurs alongside concomitant megacolon, the surgical decision requires specific consideration of the broader colonic involvement — a limited resection strategy may be inadequate in this setting.

Clinical Scenario

This protocol applies to patients presenting with sigmoid volvulus who also have concomitant megacolon. The coexistence of these two conditions directly determines the recommended extent of surgical intervention.

Surgical Approach

Management in this setting involves a surgical resection that extends beyond a limited sigmoid resection. The full protocol specifies the recommended scope of colonic resection and the rationale for this approach in patients with concomitant megacolon.

Complete operative guidance is available in the full structured protocol below.

References

DOI: 10.1186/s13017-023-00502-x

  • Patients who have concomitant megacolon and sigmoid volvulus, should undergo subtotal colectomy.
  • Sigmoid colectomy alone is insufficient as the volvulus tends to recur in the remnant segments of colon.
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