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Volvulus of the sigmoid colon in Jordan
A S Sroujieh1, G R Farah, S K Jabaiti
1Department of Surgery, Faculty of Medicine, Jordan University Hospital, Amman.
Diseases of the Colon and Rectum
|January 1, 1992
Summary
Sigmoid volvulus is a significant cause of intestinal obstruction. Endoscopic detorsion is effective, but emergency surgery is often required, especially in cases with gangrene, highlighting the need for prompt diagnosis and intervention.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Abdominal Surgery
Background:
- Sigmoid volvulus accounts for a notable percentage of adult intestinal obstructions.
- It predominantly affects individuals over 50 years old and can present acutely or chronically.
Purpose of the Study:
- To analyze the treatment outcomes of sigmoid volvulus patients at Jordan University Hospital.
- To evaluate the efficacy of sigmoidoscopic detorsion versus emergency or elective resection.
Main Methods:
- Retrospective review of 27 sigmoid volvulus patients treated over 15 years.
- Analysis of treatment modalities including endoscopic detorsion and surgical resection.
- Assessment of patient demographics, symptoms, and outcomes, including mortality.
Main Results:
- Sigmoidoscopic detorsion was successful in 15 patients, with two requiring subsequent emergency resection.
- Early recurrence was observed in two patients, managed endoscopically.
- Emergency surgery was performed in 10 patients due to failed detorsion, suspected gangrene, or misdiagnosis.
- Elective resection was performed in 13 patients.
- The overall mortality rate was 15%, with a 33.3% mortality rate in patients with gangrenous bowel.
Conclusions:
- Sigmoidoscopic detorsion is a viable initial treatment for sigmoid volvulus.
- Prompt surgical intervention is crucial for patients with gangrene or failed endoscopic management.
- Sigmoid volvulus management requires careful consideration of endoscopic versus surgical approaches based on clinical presentation and suspected complications.