Chronic Sigmoid Volvulus Necessitating Pelvic Colectomy: A Case Report and Review of the Literature
Journal Title: Journal of Surgery Research and Practice - Year 2020, Vol 1, Issue 2
Abstract
The Viennese Pathologist, Von Rokitansky, first reported the volvulus of the colon in 1896. Volvulus of the colon is said to occur when a bowel loop and its mesentery twist on a fixed point at its base. It occurs at segments of the colon where a large segment is mobile and is supported by a mesentery with a narrow base at fixation. This anatomical placement allows for axial rotation. Although, colonic volvulus usually occurs in the sigmoid or cecum, it may happen at any segment of colon. Synchronous volvulus of the sigmoid and cecum, or sigmoid and ileum may occur. Recurrent episodes of abdominal distension, constipation and abdominal pain are the most striking symptoms (the so-called sigmoid volvulus triad). The pain is generally a mild colicky type. Symptoms usually resolve with passage of flatus, rather than faeces, or following a diagnostic barium enema. Recurrent sigmoid colon volvulus is a common phenomenon, rather than a rarity and open surgical intervention is the norm in Africa, rather than endoscopic detortion. The twisted sigmoid colon in Africans is thickened, hypertrophied, with a long and thickened mesocolon and dilated mesenteric vessels. Pelvic colectomy is preferred in patients from rural areas because, they are easily lost to follow up, only to present with a gangrenous or compound volvulus; significantly increasing surgery related morbidity and mortality. No sufficient data has been found on systematic review of papers from Nigeria highlighting the paradigm shift for surgical resection over non operative procedures. The aim of this review is to investigate the extent of recurrent sigmoid colon volvulus and the role of surgical resection of sigmoid colon in African patients.
Authors and Affiliations
Aliyu S, Ningi AB
Keywords
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- EP ID EP698895
- DOI http://dx.doi.org/10.46889/JSRP.2020.1203
- Views 46
- Downloads 0
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