Final answer:
For an elderly patient presenting with a sigmoid volvulus, the correct management is usually flexible sigmoidoscopy to reduce the twisted bowel. If unsuccessful or if there are signs of more severe complications, surgical intervention may be required.
Step-by-step explanation:
An 85-year-old nursing home patient presents with symptoms suggestive of a sigmoid volvulus, as evidenced by a radiograph showing a markedly dilated loop of colon. For the management of this patient, the correct approach would be sigmoidoscopy. This procedure involves using a small camera to inspect the rectum and lower third of the colon, which is the area commonly affected by a volvulus. The flexible sigmoidoscopy can reduce the volvulus by untwisting the loop of the bowel and can also allow the insertion of a rectal tube to prevent recurrence. If the volvulus cannot be reduced by sigmoidoscopy or if the patient shows signs of strangulation or peritonitis, surgical intervention may be necessary. Colorectal cancer, which presents with overlapping symptoms, emphasizes the importance of colonoscopy, as it functions both diagnostically and therapeutically to identify and remove precancerous growths. However, in the acute setting of a sigmoid volvulus, direct intervention to address the twist is paramount.