A clinical study on the management of sigmoid volvulus

Abstract

Background: Sigmoid volvulus is a surgical emergency and significant cause of large bowel obstruction with high mortality and morbidity. The disease is more prevalent in India, especially rural population. It constitutes 15% of total bowel obstructions. This study analyzes various management options in our institute which caters mainly to patients from the surrounding rural areas.

Methods: The present work is study of 36 cases, carried out as regards to the etiological factors which predispose to the sigmoid volvulus, the clinical features, modes of treatment and the outcome. Particular stress has been laid on the various treatments. The duration study was 2 years between November 2014 and October 2016 at Government Chengalpattu medical college, Tamil Nadu, India.

Results: The mean age of sigmoid volvulus was 49 years (range 19-75) and male to female ratio was 2:1. Comparatively less frequent in less than 20 years and above 70 years. Distention of abdomen (100%), followed by constipation in 88% were common mode of presentation. Sigmoidopexy done in 22% patients with nil mortality and, for primary resection and anastomosis, it was 17%. Common post-operative complication found to be wound infections.

Conclusions: Primary resection anastamosis is found to be definitive safe procedure if the colon is viable. Hartman’s procedure is suitable only if the bowel is gangrenous. Absence of co morbid conditions a notable feature. Pre operative X-RAY helpful in diagnosis. Mortality found to be 17.5% in our study.