A Rural Center Study of Sigmoid Volvulus
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 4
Abstract
Background: Sigmoid volvulus is a condition in which the sigmoid colon wraps around itself and its own mesentery, causing a closed-loop obstruction. It is the second common cause of intestinal obstruction and surgical emergency in elderly and its mortality remains significant in patients with late diagnosis. Usually, they present with sudden pain abdomen, distention, constipation, and not passing flatus. Delay in diagnosing and intervention leads to serious complications such as intestinal obstruction, bowel gangrene, perforation, peritonitis, and sepsis and may be fatal. Materials and Methods: Between May 2015 and May 2018, 20 patients of sigmoid volvulus, who reported to the Department of General Surgery, Rajah Muthiah Medical College and Hospital, were included in the study. The aim of this work is to assess the etiological factors which predispose to the sigmoid volvulus, the clinical presentations, modes of remedy, treatment outcomes, and complications in our rural population. Results: Majority of the sigmoid volvulus occurred in the age group of above 50 years with male predominance. Almost all sufferers had mixed diet more of non-vegetarian food. Most of them belonged to poor socioeconomic group. The overall mortality was 35% in this series. Conclusion: Sigmoid volvulus is the second common cause of intestinal obstruction in elderly males in this region accounting for 40% of large bowel obstruction cases. The mortality of patients affected by sigmoid volvulus is related to the disease stage, prompt surgical timing, functional status of the patient, and his collaboration with the clinicians in the pre-operative decision-making process. Mortality is higher in both obstructed patients with generalized peritonitis and patients affected by subocclusion with late diagnosis and surgical treatment; in both scenarios, a Hartmann’s procedure is the proper operation to be considered.
Authors and Affiliations
P Ravisankar, G Ashok Swaminathan, A Anvar Ali, D Gopikrishna
Keywords
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