VOLVULUS OF THE RIGHT COLON - THE NEED FO R RIGHT HEMICOLECTOMY - REPORT ON 23 CASES

Twenty-three patients with volvulus of the caecum were Operated on fro m 1982 to 1995. There were 17 men and 6 women, mean age 63 years. Preo perative diagnosis was obtained in 48 % of the cases. A right hemicole ctomy was performed in 22 cases with immediate anastomosis; in one cas e, a double ilial and transverse stomy was required. Necrosis was obse rve in 12 patients (52 %). Post-operative mortality was 8.6 % (n = 2) due to circulatory shock in 2 patients with necrosis of the colon. Pos t-operative morbidity was 21 % (n = 5) including one case with fistuli zation of the anastomosis requiring a double stomy. On the basis of th is series and a review of the literature, it appears that right hemico lectomy is the treatment of choice for volvulus of the right colon, as it avoids all risk of recurrence and mortality is lower than conserva tive treatment.