AN EXPERIENCE OF SIGMOID COLON VOLVULUS AT EMMERGENCY WARD LRH
DOI:
https://doi.org/10.52206/jsmc.2016.6.2.798-803Abstract
BACKGROUND: Sigmoid volvulus is a serious condition due to rotation of sigmoid colon. Volvulus
often presents with abdominal colic and distention. It can be managed conservatively by colonoscopic
decompression, followed by optimization of patient and finally surgical procedure. The present study
was based on the comparison of resection of sigmoid colon and double barrel colostomy or resection and
primary anastomosis
OBJECTIVE: Objective of the study was to compare the results of primary anastomosis and colostomy
in patients presenting with sigmoid volvulus.
METHODOLOGY: In this study a total of 48 patients with sigmoid volvulus coming to Accident &
Emergency Department were included. All the patients were examined and investigated. After diagnosis
based on x-ray erect abdomen all the patients were admitted in Accident and Emergency ward. After
admission Full Blood count, urea, sugar, S. Electrolysis and ECG were also performed. Patients were
catheterized and a nasogastric tube passed for gastric decompression. All the patients were given
intravenous fluids antibiotics and prepared for surgery as facilities for colonoscopic sigmoidscopic
decompression were not available and decompressions by rectal tube was unsuccessful
RESULTS: Among the cases with sigmoid volvulus there were 36 males and 12 were females. Majority
28 cases were in age range of 61-70 years. Eight patients had gangrene of sigmoid colon, 23 patients had
resection and colostomy while 20 had resection and primary anastomosis. Among the postoperative
complications, 05 patients had wound infection and 01 wound dehiscence. Two patients died because of
sepsis and cardiopulmonary complications.
CONCLUSION: Patients presenting as acute abdomen should have urgent laparotomy as soon as
possible. Decompression by colonoscope is the gold standard procedure for stable patients with sigmoid
volvulus. Sigmoidectomy and primary anastomosis is the procedure of choice as it not only avoids
second admission and operation, but it also avoids the side effects and care of stoma, which is major
cause of morbidity and mortality.
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