Volvo de sigmoide: Aspectos diagnósticos e terapêuticos diante um relato de caso

• DOI: 10.22533/at.ed.8621913031

• Palavras-chave: volvo; volvo de sigmoide; obstrução intestinal; relato de caso.

• Keywords: volvulus, sigmoid volvulus, intestinal obstruction, case report.

• Abstract:

  Volvulus is the intestinal rotation about its mesenteric axis, most incident

  on the sigmoid colon and cecum. This pathology is associated with the elderly, chronic

  constipation and Chagas’ disease. The clinic of intestinal obstruction is characteristic,

  however, the same can be presented in a controversial way in the elderly patient. In this

  way, complementary exams, especially of image, helps the diagnostic investigation.

  The therapeutic approach can be performed via endoscopy or even surgical resection

  of the compromised intestinal segment. The present work aims to report a clinical case

  of sigmoid volvulus and for this a brief literature review was developed for theoretical

  basis. An 84-year-old woman, complaining of pain and abdominal distension, associated

  with diarrhea. She denied nausea, vomiting, or fever. She referred to comorbidities

  and previous abdominal surgery 3 decades ago. Physical examination compatible

  with intestinal obstruction and abdominal radiography revealed a “coffee bean” image,

  considering sigmoid volvo as a diagnostic hypothesis. A laparotomy was performed,

  confirming sigmoid colon torsion and adhesions and treated with retanosigmoidectomy

  to Hartmann. The patient remained under intensive care during the postoperative due

  to clinical instability, was medicated with amikacin and metronidazole, without success,

  resulting in lethal success on the fourth postoperative day. With the epidemiological

  transition and population aging, the sigmoid volvulus should be considered among the

  diagnostic hypotheses in the face of a condition suggestive of intestinal obstruction.

  Among the elderly, due to the nonspecific clinical picture, imaging tests are very useful

  for diagnostic confirmation, etiological investigation and planning of the therapeutic

  approach.

• Número de páginas: 15