Background: Sigmoid volvulus is one of the common causes of intestinal obstruction; it is frequently reported in volvulus belt including Middle and South Africa, Turkey, and Indian subcontinent. Controlling sigmoid volvulus is often difficult because of its occurrence in high-risk patients and the related perioperative illness and death rates.
Objective: To describe the clinical presentation, type of surgical procedures performed, and to determine the prognosis of sigmoid volvulus.
Materials and Methods: This was a descriptive prospective study of 70 patients admitted in the Department of Surgery at General Hospital, Ahmedabad, Gujarat, India, during the period of May 2006–January 2010. Record of age, sex, symptoms, duration, radiological findings, types of surgery performed, postoperative complications, mortality, duration of hospital stay, and follow-up data were obtained.
Result: A total of 70 patients were studied. The mean age of incidence of volvulus is around 52 years with male to female ratio around 2:1. Most of the patients presented with acute intestinal obstruction in which emergency laparotomy was performed. Resection and primary anastomosis were done in 60% of cases. Colostomy was performed in 40% of cases owing to gangrene and perforation. Surgical site infection was the most common complication with mortality of 20% owing to delayed presentation, septicemia, and associated medical illness.
Conclusion: Sigmoid volvulus is usually presented as intestinal obstruction affecting elderly male patients, which requires urgent resuscitation and surgical approach; if bowel is found viable, resection and primary anastomosis is performed, while in case of gangrenous bowel, temporary colostomy should be performed. Early diagnosis and definitive surgical treatment are needed to establish law morbidity and mortality.
Key words: Sigmoid volvulus, intestinal obstruction, clinical features, management, complications
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