A Twist in the Tale

Excerpt

We present the case of a 70-year-old gentleman who was referred to our Surgical Emergency Unit with signs and symptoms of large bowel obstruction on a background of long-standing constipation. Computed tomography confirmed sigmoid volvulus. Endoscopic decompression was unsuccessful. Although there were no findings suggestive of ischaemia or perforation, abdominal dissention and absolute constipation persisted. He underwent diagnostic laparoscopy and untorting of his sigmoid colon. In view of multiple medical comorbidities and a strong wish of the patient to avoid a stoma, the decision was taken not to perform a resection but to a laparoscopic sigmoidopexy. The sigmoid colon was fixed over its entire length to the abdominal wall with permanent metal tacks (Protack, Covidien) in an effort to prevent future volvulus. The patient made an uneventful recovery and was discharged on the third postoperative day. …