Volvulus of the sigmoid colon

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Clinical Medicine

Background:

• Sigmoid volvulus is a common cause of large bowel obstruction, particularly in certain populations.
• Patients often present with delayed diagnosis, increasing the risk of complications.
• Associated conditions like mental illness and chronic constipation are noted.

Purpose of the Study:

• To review the clinical presentation and treatment outcomes of sigmoid volvulus patients.
• To identify diagnostic challenges and effective treatment strategies.
• To determine factors influencing mortality in sigmoid volvulus.

Main Methods:

• Retrospective review of 31 consecutive sigmoid volvulus patients.
• Analysis of clinical features, diagnostic methods, and treatment interventions.
• Comparison of outcomes for conservative versus surgical management.

Main Results:

• Abdominal pain and distension were primary symptoms, present for an average of 8 days.
• Clinical diagnosis was straightforward, but bowel viability assessment was challenging; a silent abdomen indicated gangrene.
• Conservative treatment (sigmoidoscopy, barium enema) succeeded in 50% of cases.
• Sigmoid resection with end-to-end anastomosis had the lowest surgical mortality.
• Overall mortality rate was 35%.

Conclusions:

• Sigmoid volvulus requires prompt recognition and management.
• While conservative measures can be effective, surgical intervention is often necessary.
• Sigmoid resection with anastomosis is the preferred surgical approach to minimize mortality.