摘要
背景 乙狀結腸是大腸最容易發生扭轉的部位，過長的乙狀結腸會以腸繫膜為基點發生扭轉，並進而造成阻塞。乙狀結腸扭轉的發生率有其地域及種族上的特殊性。一般都好發於開發中國家，相對而言，西方及東方國家的發生率較低。這篇文章的目的是研究在單一醫學中心中，這類病患的特性及處理的方法。 材料及方法 從西元1979年到2000年，共有48位發生乙狀結腸扭轉的病患在本院接受治療。其中有41位男性和7位女性，平均年齡是62.5歲。治療後追蹤的平均時間是47個月。 結果 急性腹痛，腹脹，及便秘是最常見的主要症狀。診斷的工具有腹部X光攝影，鋇劑攝影，腹部超音波，以及腹部電腦斷層攝影。有34位病患接受手術治療，14位病患接受非手術治療。接受手術的病患中，有14位是接受緊急手術。所有的病患中只有一位死亡。治療後再次發生乙狀結腸扭轉的比率為14%。 結論 乙狀結腸扭轉在台灣並不常見，而且病患的特性比較類似西歐及北美的類型。乙狀結腸扭轉可能造成足以致命的腸阻塞，尤其是發生在年紀大或長期臥床的病患時。在治療方法的選擇上，如果沒有腸壞死的現象，則建議先以大腸鏡或乙狀結腸鏡減壓，之後再進行選擇性的手術。
並列摘要
Purpose. The sigmoid colon is the most common site for colonic volvulus. It is a long redundant sigrnoid colon twisting on its mesenteric axis in either direction, leading to a closed loop obstruction. Sigmoid volvulus has variable geographical and racial distributions, mainly in developing countries and Scandinavia, but is of relatively low incidence in the Western and Eastern countries. The purpose of this study is to evaluate the characteristics and managing policy of the patients with sigmoid volvulus in a single hospital. Materials and Methods. This retrospective study recruits 48 patients with sigmoid volvulus treated at Taipei-Veterans General hospital (TVGH) during a 22-year period (from 1979 to 2000). There were 41 males and 7females.The mean age was 62.5 years old(ranged 9-88).The averaged follow-up period was 47 months, ranged between 6 months and 12 years. Results. Acute abdominal pain, abdomen distension, and constipation were the most frequent chief complaints. The diagnostic tools included KUB, barium enema, sonography and computing tomography (CT). There were34 patients receiving operative treatment, and 14 patients receiving non-operative treatment. In the surgical group, emergent operation was performed in 14 patients, elective surgery was performed in 20 patients, and only one surgical mortality was noted. Recurrence rate was 14%. Conclusion. Sigmoid volvulus is not common in Taiwan. The characteristic of patients in this area is more similar to West European and North America. This disease is a potentially lethal intestinal obstruction, especially when it involves elderly or institutionalized patients. The choice of treatment depends on the viability of colon. If there is no gangrene or perforation, initial decompression followed by elective surgery is recommended.