COLONOSCOPIC VOLVULUS DEFLATION

1. A JOURNEY BY
FLEXIBLE
ENDOSCOPY
DR.MASFIQUE AHMED BHUIYAN
MBBS(DMC) FCPS(SURGERY)
LAPARO-ENDOSCOPIC SURGEON
DEPARTMENT OF SURGERY
DHAKA MEDICAL COLLEGE & HOSPITAL.

2. A COLONOSCOPIC SIGMOID
VOLVULUS DEFLATION AS A
RESUSCITATION TOOL IN
EMERGENCY DEPARTMENT

3. “volvulus” originates from the
Latin volvere, or
“to twist.”

4. COLONIC VOLVULUS
• when a part of the colon twists on its
mesentery.

5. CAECAL, TRANSVERSE,SIGMOID
MOST FREQUENT

6. • 15 % OF LARGE BOWEL OBSTRUCTION DUE TO
COLONIC VOLVULUS
• colonic volvulus is the third leading cause of
large bowel obstruction

7. Volvulus Belt” of Africa, the Middle
East, India, and Russia.

8. generally affects adults,
it is more common in males

9. symptoms are
abdominal pain,
distention,
and constipation

10. Plain abdominal X-ray radiographs show a
dilated sigmoid colon and multiple small or
large intestinal air-fluid levels,

11. 1976 GHAZI AND SHINYA

12. Prof Hiromi Shinya

13. Hiromi Shinya (新谷 弘実 Shin'ya Hiromi,
born 1935)
is a Japanese-born general surgeon.
He pioneered
modern colonoscopic techniques,
and invented the electrosurgical
polypectomy snare now common on
colonoscopes, allowing for removal of
colon polyps without invasive surgery.

14. Case series of volvulus deflation
Total number of procedure
17
Succesful deflation of volvulus
16
failed
1
Succes rate
94.12%

15. SELECTION CRITERIA
• DIAGNOSED WITH ACUTE SIGMOID VOLVULUS
• CLINICALLY NO SIGH OF DIFFUSE PERITONITIS
• GENERAL RESUSCITATION COMPLETED
• ASA 3 OR MORE
• EXTREME AGE

16. • ALWAYS COUNCIL THE PATIENT THAT
IT MAY BE FAILED AND PATIENT NEED
IMMEDIATE SURGERY IF ANY
COMPLICATION OCCUR.
• WE USE IV PETHIDINE ONLY
• MONITOR VITALS WITH PULSE
OXYMETER
• O2 INHALATION

18. Flexible endoscopy shows a spiral
sphincter-like twist of the mucosa

61. COLONOSCOPIC DEFLATION BEFORE
AND AFTER X RAY FILM

62. COLONOSCOPIC DEFLATION BEFORE
AND AFTER X RAY FILM

63. BRIDGE BETWEEN EMERGENCY TO
ROUTINE DEPARTMENT OF SURGERY

64. A COLONOSCOPIC VOLVULUS
DEFLATION AS A PRIMARY
RESUSCITATION TOOL IN
ACUTE SIGMOID VOLVULUS
FOLOWING DEFINITIVE
SURGERY AT A ROUTINE ONE

68. THOSE WHO ARE SLEEPING CAN
WOKE UP