For six months, a 90-year-old man in New Zealand kept landing in the same emergency room. The lower part of his colon repeatedly twisted on itself, a condition called sigmoid volvulus, and each time doctors untwisted it with a scope. As the episodes came more often, he set aside his reluctance and chose surgery to end the cycle.
His case, published in March in the Journal of Surgical Case Reports, drew attention for the blunt surgical nickname his doctors gave a complication that followed. Less noticed is the decision at its center: whether an independent 90-year-old should accept an operation to stop a problem that a scope could fix again and again, but only temporarily. Surgical guidelines and recent studies suggest that question comes up far more often than most families realize.
