[Current therapeutic attitude in volvulus of the pelvic colon in tropical areas].

Diagnosis of the acute sigmoid volvulus is made by opacification of the colon by water-soluble chemicals. Therapeutic attitude is oriented by the results of an emergency colonoscopy. An emergency laparotomy is indicated when the mucosae presents an ischemic or necrotic aspect; a resection without anastomosis is performed according to Bouilly-Volkman's intervention in the best cases, Hartman's one in others. A normal colonoscopy authorizes a medical treatment with attempt of detorsion by passage of a flatus tube per rectum. A controlled success permits a delayed intervention ten days after with resection and anastomosis. Failure of medical treatment returns the surgical approach in emergency circumstances]