Abstract

Three cases of volvulus of the sigmoid are reported, treated by intubation and laparotomy. Attention is called to the possibility of conservative management without laparotomy by intubation via proctoscope. Prompt diagnosis by physical and x-ray findings, and the absence of leukocytosis or gangrene seen by proctoscope, make the conservative treatment ideal. Review of literature shows advisability of resection only in recurrent cases during free interval, or in those cases with existing gangrene. In the latter type, the Mikulicz resection, while safest and most easily done, can be used only where all the gangrenous loop can be extruded, and this is seldom possible due to the location of the distal loop strangulation. End-to-end and side-to-side anastomoses are attended with real difficulties due to the condition of the proximal bowel and fixation of the distal loop. None of our cases was attended by gangrene.