An Update on the Current Management of Sigmoid Volvulus | Chapter 4 | Achievements and Challenges of Medicine and Medical Science Vol. 6

Sigmoid volvulus is a common cause of large bowel obstruction in older patients in the West and in younger patients in the East. The diagnosis is made by clinical examination, blood investigations and imaging modalities like X-ray and computerized tomography. Sigmoid volvulus can be divided into a complicated or uncomplicated clinical presentation. For uncomplicated sigmoid volvulus, the treatment is initially endoscopic decompression and flatus tube insertion, and this is followed by an elective sigmoid resection. For complicated sigmoid volvulus, surgical resection is the treatment of choice and Hartmann’s procedure is the most common operation as anastomosis is rarely performed. We have conducted this review article to review the current management of sigmoid volvulus.

 

Author (s) Details

Kumar H.R
Department of Surgery, Taylor’s University School of Medicine and Health Science, 47500 Subang Jaya, Selangor, Malaysia.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v6/3448

Rare Presentation of Sigmoid Volvulus with Perforated Appendicitis-A Case Report from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia | Chapter 7 | New Visions in Medicine and Medical Science Vol. 8

Sigmoid volvulus, primarily affecting males, often leads to large bowel obstruction, with management outcomes contingent upon the patient's initial clinical status. Typically, open or laparoscopic surgery is the preferred treatment, barring instances where conservative management is prioritized, especially for surgically unfit patients. Rectal deflation serves as a conservative option, particularly in emergency outpatient settings, aimed at preparing patients for semi-elective or elective procedures. In a recent case, despite an initially smooth clinical condition, a patient diagnosed with simple sigmoid volvulus failed deflation attempts. Subsequently, surgery was performed on the third-day post-failure, revealing colonic perforation distal to the obstruction and perforated appendicitis. Notably, the cause of the appendicitis remains unclear—whether primary or secondary to the volvulus. Additionally, there are no reported instances of perforated appendicitis as a common complication of sigmoid volvulus.

Author(s) Details:

Dr. Wondwossen Amtataw,
Department of Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.

Dr. Feven Berhanu
Department of Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.

Dr. Surafel Mulatu
Department of Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.

Please see the link here: https://doi.org/10.9734/bpi/nvmms/v8/23

Adult Sigmoid Volvulus in a Referral Hospital in East Africa | Chapter 10 | Current Innovations in Medicine and Medical Science Vol. 2

 The purpose of this study was to report the presentation and management of a case of uncomplicated sigmoid volvulus in a referral hospital in East Africa. Sigmoid volvulus occurs due to twisting of the enlarged loop of the sigmoid colon about its mesenteric axis, resulting in acute colonic obstruction and eventual entrapment of the colon. A 46-year-old man had complained of his 7-day stomach pain, inability to defecate, and bloating. His abdomen was tympanic, distended and nontender. After his resuscitation, a laparotomy was performed, revealing volvulus of the sigmoid colon without intestinal ischemia or gangrene. A one-stage sigma colectomy and primary anastomosis were performed, and the patient recovered without complications. Endoscopic decompression is not available in East African emergency scenarios. Our patient underwent emergency laparotomy because he had a simple sigmoid torsion and no endoscopic torsion or rectal tube insertion. There was no morbidity after colon sigma resection and primary anastomosis. He recovered without complications. Single-stage sigma colectomy is reported to have a  mortality rate of 7.7% in East Africa. Septic shock is the leading cause of death in patients presenting with volvulus of the sigmoid colon. Early diagnosis and prompt treatment are necessary to  reduce morbidity and mortality in patients with intestinal obstruction due to volvulus of the sigmoid colon.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

Please see the link here: https://stm.bookpi.org/CIMMS-V2/article/view/8227

Incidence and Factors Influencing the Outcome of Sigmoid Volvulus in Northern Uganda. A Prospective Observational Study | Chapter 2 | Highlights on Medicine and Medical Science Vol. 5

 Introduction: Sigmoid volvulus (SV) is one of the commonest causes of intestinal obstruction in Uganda. The purpose of this study was to determine the incidence and the factors influencing the outcome of management of SV in Northern Uganda Methodology: This study was divided into two parts. The purpose of the retrospective study was to determine the incidence over a two-year period. Patients 13 years and older with SV were included in the one-year prospective study to determine the factors influencing outcome and were followed up to the 30th postoperative day. The Gulu University IRB provided ethical approval. STATA/IC version 12.1 was used for data analysis. The end result was an uneventful recovery, morbidity, and mortality. In Northern Uganda, the incidence of SV was 251.8 per 100,000 surgical population in two years. Data from 103 patients were analyzed; 18 (17.48 percent) of them developed complications such as wound sepsis (10.7%), wound dehiscence (8.7%), and anastomotic leak (8.7%). (7.7 percent ). There were 8 deaths, for a 7.7 percent mortality rate. Hypernatraemia (RR=14.9; 95 percent CI: 1.46-152.9) and ileo-sigmoid knotting (RR = 4.94; 95 percent CI: 1.3018.78) were factors associated with a high risk of adverse outcome. When compared to Hartmann's procedure, resection and primary anastomosis had a better outcome (RR=0.15; 95 percent CI: 0.02- 0.099). In Northern Uganda, the incidence of SV was 251.8 per 100,000 surgical population in two years. Preoperative hypernatraemia and ileo-sigmoid knotting were risk factors for morbidity and mortality. Colostomy had a higher risk of morbidity and mortality than resection and primary anastomosis.

Author (s) Details

Richard Wismayer
Department of Surgery, Faculty of Medicine, University of Edinburgh, United Kingdom and Department of Surgery, Faculty of Medicine, Gulu University, Gulu, Uganda.

View Book :- https://stm.bookpi.org/HMMS-V5/article/view/1727