Treatment of Volvulus of the Sigmoid Colon and Cecum

Nay, Howard R.

doi:10.1001/archsurg.1967.01330070013003

Cited by 23 publications

(9 citation statements)

References 7 publications

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“…In the present series, the majority (74%) of gangrenous cases were suitable for resection, as was also found by Nay & West (1967) and Hines et al (1967). Anastomoses were fashioned in two layers without tension.…”

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confidence: 88%

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Sigmoid Volvulus

Rennie

1979

J R Soc Med

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confidence: 88%

“…Volvulus of the sigmoid colon is a rare surgical condition in Western countries (Nay & West 1967), but is more common in Eastern Europe, parts of India, Africa (Shepherd 1969) and South America (Martiano Melo 1966). In India there is a great variation between East and West and different ethnic groups (Anderson 1956).…”

mentioning

confidence: 99%

Sigmoid Volvulus

Rennie

1979

J R Soc Med

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“…In other parts of the world sigmoid volvulus is one of the more common causes of large-bowel obstruction and in the Middle East it is about four times as common as in Western countries (Nay and West, 1967). Other parts of Africa have an even higher incidence and recent reports from East Africa (Shepherd, J. J., 1968,1969) have discussed thoroughly the management of the early case.…”

Section: Discussionmentioning

confidence: 99%

“…The Paul-Mikulicz resection is the classic operation for gangrenous sigmoid volvulus and is still recommended as the treatment of choice (Nay and West, 1967;Rains and Capper, 1968;Farquharson, 1969). The disadvantages of this procedure are that only a limited colonic resection is possible and that the inferior mesenteric vessels may be pulled up close to the abdominal wall and rendered liable to injury (Hughes, 1969).…”

Section: Discussionmentioning

confidence: 99%

“…Obstruction due to volvulus has not escaped this trend and primary resection has been advocated both for volvulus with a viable colon (Hughes, 1969) and in the presence of gangrene (Hines, Guerkink, and Bass, 1966; Nay and West, 1967 Hughes, 1969) and it carries about the same mortality as a Mikulicz resection under these conditions (Scott, 1965; Shepherd, J. J., 1968). Most of these patients are poor surgical risks and complications at the anastomosis are more likely to occur when the colon is unprepared and dilated (Wuepper and others, 1966).…”

Section: Discussionmentioning

confidence: 99%

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The management of gangrenous sigmoid volvulus

Neely

1970

Journal of British Surgery

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SUMMARYFive patients with volvulus of the sigmoid colon complicated by gangrene are reported, in none of whom was a Mikulicz exteriorization resection possible due to the extent of the gangrene. T h e pathogenesis of gangrene in this condition is discussed and the literature reviewed. It is concluded that the procedure of choice is Hartmann's operation, that primary resection with anastomosis is permissible under optimal conditions, and that the Mikulicz exteriorization resection is best avoided.VOLVULUS of the sigmoid colon is a rare surgical emergency in Western countries and few British surgeons have much practical experience of the management of this condition; major British hospitals admit an average of only I case a year (Bolt, 1956). In other parts of the world sigmoid volvulus is one of the more common causes of large-bowel obstruction and in the Middle East it is about four times as common as in Western countries (Nay and West, 1967). Other parts of Africa have an even higher incidence and recent reports from East Africa (Shepherd, J. J., 1968,1969) have discussed thoroughly the management of the early case. However, there is still some doubt as to the best way of dealing with the volvulus complicated by gangrene (Shepherd, J. J., 1968) and, although personal experience will be slow to accumulate, the condition occurs with sufficient frequency to merit a clear policy of management (Hughes, 1969). I t would therefore seem appropriate to report the experience with 5 such patients seen recently in Libya, and review the problem.Libya is a country of about 700,000 square miles, which are largely desert, with the population mainly scattered along a narrow coastal fringe. Communication with the interior is by air but, even so, patients from a distance may not reach a major hospital until several days after the onset of their illness. T h e largest hospital in the country is the Central Government Hospital in the capital, Tripoli, where the reported patients were seen. This hospital has facilities for major emergency surgery but blood for transfusion is in extremely short supply. Owing to the language barrier an accurate history was difficult to obtain and the preoperative diagnosis was made largely from the clinical examination. Sigmoidoscopy was not performed on any of the reported patients as it was considered that their abdominal signs necessitated laparotomy.T h e operations were carried out by two surgeons:Dr. Bertrando Fochi, who had responsibility for the female patients, and the author, who looked after the male patients. CASE REPORTSCase x.-G. N., a man of 65 years, was admitted to hospital as an emergency with a 5-day history of colicky abdominal pain and absolute constipation. Over the 2 days preceding admission he had been vomiting repeatedly and had become oliguric. As far as could be ascertained, he had been in previously good health without anv abdominal symptoms.On examination he was severely shocked with cold, clammy extremities, a pulse-rate of 120 per minute, and a systolic blood-pressure of...

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Volvulus of the Colon

Kerry¹

1969

Arch Surg

112

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Treatment of Volvulus of the Sigmoid Colon and Cecum

Cited by 23 publications

References 7 publications

Sigmoid Volvulus

Sigmoid Volvulus

The management of gangrenous sigmoid volvulus

Volvulus of the Colon

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