Sigmoid volvulus - an important cause of intestinal obstruction: how to deal with it?

Abstract

Background: The objective of the study was to discuss the appropriate course of action in cases of sigmoid volvulus. It becomes important due to its high morbidity and mortality and its acute emergency presentation.Methods: This is a retrospective study of sigmoid volvulus admitted in the department of surgery at Late SBRKM Government Medical College, Jagdalpur. The study period was from January 2017 to August 2019. A total of 27 cases were under study. On admission, they were examined, investigated and treated surgically and the outcome noted.Results: Out of 27 patients 25 were male and 2 cases were female. The mean age group was 65 years. The co-morbidities consisted of previous abdominal surgeries, diabetes mellitus, hypertension, and renal complications. The common factor was chronic constipation and purgative abuse. All underwent a definitive surgical procedure like sigmoidectomy and colorectal anastamosis or sigmoidectomy and colostomy. In the second group colostomy closure and end to end anastamosis carried on at a later date. We have lost 5 patients in the post-operative period.Conclusions: The sigmoid volvulus presents with the features of intestinal obstruction. The real danger is the gangrene of the bowel, as a consequence of ischaemia. It requires an early surgical intervention for the maximum benefit of the patient.

Spontaneous decompression of sigmoid volvulus

“…1,2,[7][8][9] Abdominal pain/tenderness, distention, and obstipation/constipation are the main features. 10,[14][15][16][17] Abdominal x-ray radiography presents a dilated sigmoid colon (Fig. 1a), while CT is preferred due to its higher diagnostic value with the same finding in addition to mesenteric whirl sign (Fig.…”