Emergency Management of Sigmoid Colon Volvulus in a Volvulus Belt Population and a Review of Literature

Colonic Volvulus: An Experience at Tertiary Care Hospital in Nepal

“…We found colonic volvulus in 16% of all intestinal obstruction cases and specifically in 65% of total large intestinal obstruction cases in our series similarly reported from the other developing countries from Asia [8]. Mean age of our patient was 57.9 ± 10.4 and male preponderance (74.2%) in our study is comparable to the other ‘‘volvulus belt’’ countries [8]. In the Western world, elderly males ( age >70 ) are at higher risk of developing sigmoid volvulus while caecal volvulus affects younger females (age ≤ 60) which have been reported in the study by Halabi et al [3].…”

“…Volvulus of the colon is common in endemic regions than Western Europe and the United States [1]. We found colonic volvulus in 16% of all intestinal obstruction cases and specifically in 65% of total large intestinal obstruction cases in our series similarly reported from the other developing countries from Asia [8]. Mean age of our patient was 57.9 ± 10.4 and male preponderance (74.2%) in our study is comparable to the other ‘‘volvulus belt’’ countries [8].…”

Comments on ‘Colectomy for caecal and sigmoid volvulus: a national analysis of outcomes and risk factors for postoperative complications’

“…After propensity score matching, Dolejs et al [8] reported a 10.8% mortality rate in 232 SV patients treated with emergency colectomy and primary anastomosis in the same period (between 2012 and 2015) by using the same database (American College of Surgeons National Surgical Quality Improvement Program). The mortality rate is 7.4% in a 270-patient series by Pattanaik [9] and it is 16.7% in a 102-patient series by Chalya and Mabula [10]. In our series, although there were no elective deaths in 114 patients, the mortality rate was 12.7% in the 166 emergency patients treated with sigmoid colectomy and primary anastomosis.…”

Comments on ‘Emergency Management of Sigmoid Colon Volvulus in a Volvulus Belt Population and a Review of Literature’

“…Dear editor, I read with interest the article titled 'Emergency Management of Sigmoid Colon Volvulus in a Volvulus Belt Population and a Review of Literature' by Pattanaik [1], who reported 445 patients with sigmoid volvulus (SV). Among a large number of evaluated subjects including epidemiology, diagnosis, and treatment of SV, I want to discuss some subjects including the complexity of the strategy for emergency management, the utilization of the endoscopes in non-operative treatment, and the recommendation of the emergency laparotomy in almost all cases.…”

“…As known, SV is endemic in India [1], where the author practices. Therefore, I hope that the author has at least a few-case experience with non-operative detorsion of SV.…”