Introduction Patients with sigmoid volvulus (SV) are at a high risk of recurrence with increased morbidity and mortality. This study aims to review whether patients with SV underwent definitive surgical treatment after initial endoscopic reduction according to the guidelines, and to compare mortality rate between surgical and conservative management. Methods Retrospective study conducted at East Kent Hospitals University NHS Foundation Trust, included all patients with SV between 2016 and 2018. The primary outcome was 30-day mortality following the initial management of the acute attack. Secondary outcomes were recurrence rate and overall mortality. The median follow-up period was 3 years. Results A total of 40 patients were identified with a median age of 82 years; 27 (67%) were males. Of these 40 patients, 6 (15%) had emergency surgery, 26 (65%) received endoscopic decompression only, and 8 (20%) had planned definitive resection; 32 patients (80%) had recurrence and the median interval between any two episodes was 86 days. The mortality rate among patients with ASA grade 3 or 4 in the three groups, elective surgery, emergency surgery and decompression only, was 0%, 25% and 70% respectively, whereas it was 0%, 50% and 33% in those with ASA grade 2. The mortality rate among patients with similar ASA who had a planned surgery was significantly lower compared with those who did not undergo surgery (p=0.003). Conclusions In patients with sigmoid volvulus, regardless of ASA grade, performing early definitive surgery following initial endoscopic decompression resulted in a statistically significant lower mortality rate.
Morbidity and mortality are significantly associated with perforated appendicitis as compared to the nonperforated. The complications can be decreased if preventable measures are taken to avoid the delay in reporting patients to the health care services. To conclude, the correlation between acute appendicitis and family history is strong for the first and second degree, and clearly, it is more significant in patients who are below 30 years old. Clinically, it is believed that the family history of appendicitis may help the physicians or doctors in raising the index of suspicion of acute appendicitis. Surgery Curr Res, an open access journal 2161-1076 Volume 8 • Issue 2 • 1000316 8. Ergul E (2007) Heredity and familial tendency of acute appendicitis. Scand J Surgery 96: 290-292.Secondly, we were not able to reach all patients who underwent positive appendectomies during the retrospective time frame set for our study to gather a larger number of cases.
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