Colonic Volvulus

Recurrence rate after endoscopic detorsion ranges from 30-90%.  Morbidity and mortality increases with each successiev detorsion.
- mortality of elective resection is low (1-5%), recurrence rate after resection low (~5%).
- If operative risk is too high - consider percutaneous endoscopic transcolonic tube placement

- recurrence rate of cecal volvulus is also high (20-40%): cecopexy or resection with primary anastamosis are eqully safe with similar recurrence rates (5-15%)