Experience of Surgical Procedure in the Management of Sigmoid Volvulus
Abstract
Introduction: Sigmoid Volvulus is the most common type of volvulus, accounting for 75 to 90% of all volvulus. Most common presenting symptom is abdominal pain, distension and constipation. Numerous surgical and non-surgical treatments have been described to relieve this condition. The primary objective of the study is to demonstrate the most suitable surgical procedure for management of patients with sigmoid volvulus presented in emergency.
Method: Retrospective study was carried out in the Department of surgery from January 2010 to December 2014. 58 patients with sigmoid volvulus admitted in emergency ward, 55 patients were included in the study and 3 patients excluded. Comparison was done with respect to mortality and early morbidity associated with definitive surgical procedures. (Hartmann’s procedure versus resection and anastomosis with lord’s dilatation).
Result: In all patients after investigations and resuscitation surgical treatment was done. Hartmann’s procedure was done in 16 patients (29.09%), primary resection and anastomosis with lord’s dilatation was done in 39 patient (70.90%). 3 patient died before any intervention were not included in study. Over all mortality was 21.81% in the study.
Conclusion: Resection and anastomosis with lord’s dilatation is procedure of choice in viable bowel while Hartmann’s procedure is procedure of choice in gangrenous bowel or when the condition of patient is poor.
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References
2. Safioleas M, Chatziconstantion C, Felekouras E, Stamatakos M, Papaconstantinou I, Smirnis A, et al. Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly: a study of 33 cases. World J, Gastroenterol 2007 Feb; 13(6):921-4. [PubMed]
3. De U. Sigmoid volvulus in rural Bengal. Trop Doct 2002 April; 32(2): 80-2. [PubMed]
4. Khan M, Ullah S, Jan MAU, Naseer A, Ahmad S, Rehman A. Primary anastomosis in the management of acute sigmoid volvulus with out colonic lavage. J Postgard Med Inst 2007; 21:305-8.
5. Agaoglu N, Yucel Y, Turkyilmaz S, Surgical treatment of the sigmoid volvulus. Acta Chir Belg 2005 Aug; 105(4):365-8. [PubMed]
6. Lau KC, Miller BJ, Schache DJ, Cohen JR. A study of large-bowel volvulus in urban Australia. Can J Surg 2006 Jun; 49(3):203-7. [PubMed]
7. Turan M1, Sen M, Karadayi K et al. Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process. Rev Esp Enferm Dig. 2004 Jan;96(1):32-5. [PubMed]
8. Hadi A, KHAN N, Shah SMA, Bangash A, Emergency management of sigmoid Volvulus: experience of Lady Reading Hospital Peshawar. J Postgrad Med Inst Jan – Mar 2006; 20(1):82-5. [PubMed]
9. Dulger M, Canturk NZ, Utkan NZ, Gonullu NM, Management of sigmoid colon volvulus. Hepatogastroenterology. 2000 Sep-Oct;47(35):1280-3. [PubMed]
10. Heis H, Bani-Hani K, Rabadi D, Elheis M, Bani-Hani B, Mazabreh T, et al. .Sigmoid volvulus in the Middle East World J Surg. 2008 Mar;32(3):459-64. doi: 10.1007/s00268-007-9353-3. [PubMed]
11. Tiah L, Goh SH, Sigmoid volvulus.diagnostic twists and turns. Eur J Emerg Med. 2006 Apr;13(2):84-7. [PubMed]
12. Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Basoglu M, Polat KY, et al. An algorithm for the management to sigmoid colon volvulus and the safety of primary resection experience with 827 cases. Dis colon Rectum 2007 April; 50(4):489-97. [PubMed]
13. Khanna A, Kumar P, Khanna R, Sigmoid volvulus study from a North India hospital. Dis Colon Rectum. 1999 Aug;42(8):1081-4. [PubMed]
14. Bhatnagar BN, Sharma CL, Gautam A, Kakar A, Reddy Dc. Gangrenous sigmoid volvulus: a clinical study of 76 patients. Int J Colorectal Dis. 2004 Mar;19(2):134-42. Epub 2003 Sep 4. [PubMed]
15. Raveenthiran V. Restorative resection of unprepared left-colon in gangrenous vs. viable sigmoid volvulus. lnt J Colorectal Dis 2004 May; 19(3):258-63. [PubMed]
16. .Daneil IR, Simon JN. Minimizing recurrence after sigmoid volvulus. Br J Surg. 1999 Jul;86(7):966-7. [PubMed]
17. Bagarani M, Conde AS, Longo R, Italiano A, Terenzi A, Venuto G, - Sigmoid volvulus in west Africa: a prospective study on surigical treatments. Dis Colon Rectum 1993 Feb; 36(2): 186-90.
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