SIGMOID VOLVULUS

SIGMOID VOLVULUS FREQUENCY OF POST-OPERATIVE COMPLICATIONS OF PRIMARY REPAIR.

Abstract

Introduction: Sigmoid volvulus is the surgical emergency and significant cause
of large bowel obstruction in with high morbidity and mortality. Disease is more prevalent in
developing countries than developed countries. It contributes 15% of total bowel obstruction.
Resection and primary anastomosis is the procedure of choice. It obviates the need of
colostomy and subsequent reversal. Objectives: To determine the frequency of postoperative
complications of primary repair in patients with either viable or gangrenous sigmoid volvulus.
Study Design: Retrospective study. Setting: Surgical Unit 1 of Peoples Medical College
Hospital now Medical University. Period: 2007 to Dec. 2013. Methodology: Patients with large
bowel obstruction suspected to have sigmoid volvulus on clinical and radiological grounds were
studied. Laparotomy and resection of sigmoid colon followed by restoration of the continuity of
the colon by single layer primary anastomosis were performed without colostomy. Results: In a
total 50 patients, sigmoid volvulus male female ratio was 9:1. Mean age was 49 years majority of
the patients were in 6th to 7th decade of age. In 96% cases abdominal pain was the 1st symptom
followed by constipation and distention, vomiting was the rare symptom. Different postoperative
complication results were surgical site infection was the commonest complication in 40 (80%)
while in 1 (2%) leak was there with mortality of only 1(2%) case. Conclusion: Primary resection
and single stage anastomosis is the best choice for the management of sigmoid volvulus
disease in both possibilities of viable or non viable gut provided patients condition is stable. It
obviates the burden of colostomy