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Sigmoid Volvulus
There's a high long term recurrence rate after the initial andiscopic dcompression. So you should consider these patients for a sigmor collectome during the index admission of inappropriate patients. If on this c t scan you see no colonic eschema or perforation, the first step is endoscopic detortion. Thatd l i and th calonic lavage with antigrade vancamis and animas are surgical options.