TWIST ME ONCE, SHAME ON YOU... TWIST ME THRICE: TIME FOR THE KNIFE! horaciosousa98@gmail.com

PE087

TWIST ME ONCE, SHAME ON YOU... TWIST ME THRICE: TIME FOR THE KNIFE!

7

Portugal

Poster Exhibition only

Sigmoid volvulus is a frequent cause of large bowel obstruction, particularly in elderly patients with a redundant sigmoid colon. Although endoscopic decompression is effective in the acute setting, recurrence is common in anatomically predisposed individuals.

We report the case of a 77-year-old man with three episodes of sigmoid volvulus in under a month, all initially managed by endoscopic decompression. He was admitted to our institution after a third recurrence, with imaging confirming volvulus in a markedly redundant colon. Two further endoscopic decompressions were performed during hospitalization, while awaiting definitive surgical treatment.

The patient underwent hand-assisted laparoscopic sigmoidectomy with colorectal latero-terminal anastomosis. The procedure included vascular ligation at the origin of the inferior mesenteric vessels and segmental resection from the proximal sigmoid to the rectosigmoid junction. A mini-laparotomy with hand assist device was required due to significant colonic distension and redundancy. The postoperative course was uneventful, and the patient was discharged on day 7. No recurrence has occurred to date.

This case underscores the importance of early surgical intervention in patients with recurrent sigmoid volvulus. Hand-assisted laparoscopic sigmoidectomy offers a safe and effective solution, combining the benefits of minimally invasive surgery with secure anatomical correction. Surgical resection should be promptly considered in anatomically predisposed patients to prevent recurrence and potential complications.