CLINICAL STUDY OF TORSION OF THE SIGMOID COLON

Torsion of the sigmoid colon is a rare disease. However, the authors have experienced 15 cases of this disease over the past 20 years. The disease is commonly found in aged people. But its characteristics remain unclear. The reason might lie in different etiologies. In order to elucidate the etiology of the disease, the 15 cases were studied by dividing them into A : younger group (under 50 years ; 6 cases) and B : aged group (over 50 years ; 9 cases). The younger group consisted of one male and five females with ages ranging from 14 to 41 years (on average : 29.5), and predominantly had congenital factors such as Hirschsprung's disease, mesenterium commune, and dementia. The six younger patients underwent 11 treatments, including one patient undergoing operative detorsion only. The aged group was comprised of six males and three females with ages ranging from 55 to 80 years (on average : 68.9). In this group, it could be infered that some acquired causes such as chronic constipation had contributed to torsional anatomical causes such as sigma elongatum mobile, leading to the torsion. Conservative treatment with endoscopic detorsion was performed in three cases. The authors experienced one case which was difficult to treat conservatively, and might be susceptible to recurrence of indefinite onset.