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Sigmoid volvulus among Africans in Durban
1Department of Surgery, University of Natal, Durban, South Africa.
Tropical and Geographical Medicine
|January 1, 1995
Summary
Sigmoid volvulus in Durban predominantly affects young males, differing from other regions. Early surgical resection is recommended to reduce high mortality associated with emergency operations.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Abdominal Surgery
Background:
- Sigmoid volvulus is a common cause of intestinal obstruction in certain populations.
- Previous studies indicate varying demographics and management strategies globally.
- Understanding local patterns is crucial for effective treatment.
Purpose of the Study:
- To investigate the demographic patterns, clinical presentation, and management outcomes of sigmoid volvulus.
- To compare the findings with existing literature from Africa and Western societies.
- To evaluate the efficacy and safety of different treatment modalities.
Main Methods:
- Retrospective study of 90 patients treated for sigmoid volvulus over 7 years.
- Analysis of patient demographics, clinical features, management approaches, and outcomes.
- Comparison of outcomes between conservative, semi-elective, and emergency surgical interventions.
Main Results:
- A 9:1 male preponderance was observed, with 64% of patients under 50 years.
- Intestinal obstruction was the primary presentation in 84% of cases.
- Morbidity was 20% and mortality was 12%, with 80% of deaths in the emergency surgery group.
Conclusions:
- The pattern of sigmoid volvulus in Durban Africans differs significantly from other reported series.
- Emergency surgery for sigmoid volvulus is associated with substantial mortality, even in younger patients.
- Proactive sigmoid resection during the same admission is advocated to prevent recurrence and reduce mortality.