Management of Acute Sigmoid Volvulus in a Tertiary Centre. A time to welcome Resection Anastomosis Primarily
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 4
Abstract
To describe the management of sigmoid volvulus in a tertiary centre and to determine the prognosis of sigmoid volvulus after undertaking different surgical procedures. Study Design: A prospective case series. Place and Duration of Study: Rajendra Institute of Medical Sciences, Ranchi, Jharkhand for 18 months. Methodology: A total of 60 cases of colonic obstruction were reviewed. Demographic, laboratory and treatment results, mortality and complications were recorded. The data was analysed using descriptive statistics as frequency and percentage for the qualitative variables and mean and standard deviation values for the quantitative variables MedCalc software used for data analysis. Results: The mean age of presentation was 51.8 years with around 80% male. After initial resuscitation the patients were planned for exploratory laparotomy and the most common cause found intraoperatively was a neoplastic growth. The most common procedure performed was resection with anastomosis (38.3%). The overall mortality of the study was around 13% while the post operative mortality was 10%. The most common post operative trouble was surgical site infection (12.72%) Conclusion: In contrary to the belief of a time consuming procedure with a doubtful outcome surgeons still prefer a diversion ileostomy. However a single procedure is sufficient to tackle the patient’s pathology and prevent him undergoing another surgical procedure. We found the primary anastomosis as the optimum procedure in a viable gut during emergency.
Authors and Affiliations
Dr. Mrigendra Kumar Rai
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