Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus

2007 ◽  
Vol 193 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Alper Akcan ◽  
Hizir Akyildiz ◽  
Tarik Artis ◽  
Namik Yilmaz ◽  
Erdogan Sozuer
Keyword(s):  
Primary Anastomosis ◽  
Sigmoid Volvulus ◽  
Single Stage

scholarly journals Is single-stage resection and anastomosis for acute sigmoid volvulus, without intra operative colonic lavage a safe procedure?

2021 ◽  
Vol 28 (06) ◽  
pp. 872-875
Author(s):  
Muhammad Bilal ◽  
Viqar Aslam ◽  
Waqas Jan ◽  
Zaheer Udin
Keyword(s):  
Primary Anastomosis ◽  
Mechanical Bowel Preparation ◽  
Sigmoid Volvulus ◽  
Single Stage ◽  
Safe Procedure ◽  
Local Data ◽  
Cross Sectional ◽  
Female Ratio ◽  
Colonic Lavage ◽  
Resection And Anastomosis

Objective. This study was conducted to provide local data regarding the results and post-operative complications after single-stage resection and anastomosis for acute sigmoid volvulus, without intra operative colonic lavage. Study Design: Descriptive Cross Sectional. Setting: DHQ Charsadda. Period: May 2017 to December 2019. Material & Methods: This clinical study was done on 50 patients who presented with the signs and symptoms of acute sigmoid volvulus excluding those with complications of the illness such as gangrene, perforation and peritonitis. Surgery for all patients was carried out under General anaesthesia. All the patients underwent emergency resection and primary anastomosis, without mechanical bowel preparation. Data were collected regarding post operation complication and analysis by using SPSS version 23. Chi square test was used to compare at level of significance <0.005. Results: Median age of patients was 50 years with male to female ratio 5:3. Seven patients presented with wound infection, one dehiscence while zero Anastomotic leakage and zero death postoperative recorded. Conclusion:  Single stage resection and primary anastomosis without preoperative colonic lavage for acute sigmoid volvulus is a simpler and short procedure with low mortality and morbidity rates.

Sigmoid Volvulus in 16-year-old Boy with an Associated Anomalous Congenital Band

2013 ◽  
Vol 79 (11) ◽  
pp. 1140-1141 ◽  
Author(s):  
Ann A. Albert ◽  
Tracy L. Nolan ◽  
Bryan C. Weidner
Keyword(s):  
Abdominal Pain ◽  
African American Male ◽  
Pediatric Patients ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Sigmoid Volvulus ◽  
Sudden Onset ◽  
Contrast Enema ◽  
Pediatric Age Group ◽  
History Of

Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CTwas consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient.

scholarly journals Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi

2021 ◽  
Vol 18 (3) ◽  
pp. 176-179
Author(s):  
Ephraim Bitilinyu-Bangoh ◽  
Fatsani Mwale ◽  
Loveness Ulunji Chawinga ◽  
Gift Mulima
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Anastomosis ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
Sigmoid Resection ◽  
Sigmoid Volvulus ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Kamuzu Central Hospital

Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to  describe the surgical  management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data  extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid  resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in  mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has  significant oedema or is gangrenous.

scholarly journals SIGMOID VOLVULUS

2018 ◽  
Vol 25 (10) ◽  
pp. 1562-1567
Author(s):  
Ali Akbar Ghumro ◽  
Altaf Hussain Ghumro ◽  
Abdul Hakeem Jamali
Keyword(s):  
Primary Repair ◽  
Primary Anastomosis ◽  
Single Layer ◽  
Developed Countries ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
High Morbidity ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Medical University

Introduction: Sigmoid volvulus is the surgical emergency and significant causeof large bowel obstruction in with high morbidity and mortality. Disease is more prevalent indeveloping countries than developed countries. It contributes 15% of total bowel obstruction.Resection and primary anastomosis is the procedure of choice. It obviates the need ofcolostomy and subsequent reversal. Objectives: To determine the frequency of postoperativecomplications of primary repair in patients with either viable or gangrenous sigmoid volvulus.Study Design: Retrospective study. Setting: Surgical Unit 1 of Peoples Medical CollegeHospital now Medical University. Period: 2007 to Dec. 2013. Methodology: Patients with largebowel obstruction suspected to have sigmoid volvulus on clinical and radiological grounds werestudied. Laparotomy and resection of sigmoid colon followed by restoration of the continuity ofthe colon by single layer primary anastomosis were performed without colostomy. Results: In atotal 50 patients, sigmoid volvulus male female ratio was 9:1. Mean age was 49 years majority ofthe patients were in 6th to 7th decade of age. In 96% cases abdominal pain was the 1st symptomfollowed by constipation and distention, vomiting was the rare symptom. Different postoperativecomplication 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 resectionand single stage anastomosis is the best choice for the management of sigmoid volvulusdisease in both possibilities of viable or non viable gut provided patients condition is stable. Itobviates the burden of colostomy

Article Commentary: The Twisted Colon: A Review of Sigmoid Volvulus

2012 ◽  
Vol 78 (3) ◽  
pp. 271-279 ◽  
Author(s):  
Stephen B. Osiro ◽  
Debbie Cunningham ◽  
Mohammadali M. Shoja ◽  
R. Shane Tubbs ◽  
Jerzy Gielecki ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Primary Anastomosis ◽  
Sigmoid Resection ◽  
Sigmoid Volvulus ◽  
Mortality Data ◽  
Abdominal Radiography ◽  
Plain Abdominal Radiography ◽  
Confirmatory Tests ◽  
Sporadic Cases ◽  
Tomography Scan

Sigmoid volvulus (SV) is the third leading cause of colon obstruction in adults. In infants and children, it is exceedingly rare with only sporadic cases reported so far. SVs from secondary causes, with congenital megacolon being the most important, are nevertheless more common in young people. The etiology of this disorder is not completely understood. It is known to occur in the setting of redundant sigmoid loop, which rotates around its narrow and elongated mesentery. Although the latter occurs in the setting of constipation, a congenitally elongated colon, and other predisposing factors, there is no consensus on the precipitating factor leading to SV formation. The symptoms are suggestive of small bowel obstruction, but the presentations can be acute or indolent. Plain abdominal radiography is used to diagnose SV in most cases with computed tomography scan or magnetic resonance imaging as the confirmatory tests when necessary. After it has been untwisted, the definitive and standard therapy for SV is sigmoid resection and primary anastomosis. The nonresective alternatives have also been widely used with mixed success, but a large, randomized controlled trial is needed to compare their efficacy with resection and primary anastomosis. Laparoscopic surgery in SV management is unwarranted and costly. Complications of SV include hemorrhagic infarction, perforation, septic shock, and death. The mortality data from SV vary, but the latest literature cites an overall range of 14 to 45 per cent.

scholarly journals Sigmoid Volvulus in the Developing Countries: The Lack of Resources Might be a Blessing in Disguise

2021 ◽  
Author(s):  
Atef MEJRI ◽  
Khaoula Arfaoui ◽  
Sarra Saad ◽  
Jasser Rchidi ◽  
Ahmed Omri ◽  
...  
Keyword(s):  
Developing Countries ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Primary Anastomosis ◽  
Sigmoid Volvulus ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Epidemiological Features ◽  
The Mean ◽  
Gangrenous Bowel

Abstract BackgroundSigmoid volvulus is the most common type of volvulus. Its epidemiological features as well as its management differ between developed and developing countries. Tis work aims to analyze the epidemiological features and to access the surgical management of sigmoid volvulus in Tunisia, which is a developing country from North Africa and where there is a paucity of information regarding sigmoid volvulus.MethodsThis is a retrospective review of 64 patients with sigmoid volvulus treated in the General Surgery department of Jendouba Hospital in Tunisia from January 2005 to December 2019. In the absence of endoscopic management, all patients underwent surgical treatment.Results:64 patients were treated for acute sigmoid volvulus. There were 54 (84.4%) men with a male to female ratio of 5.4/1. The mean age was 62 years. The classic triad of abdominal pain, abdominal distention and constipation was reported in 56 (87.5%) patients. The mean duration of symptoms was 4.2 days. The accurate preoperative diagnosis was made in 58 (90.62%) cases. Forty patients (74%) had viable bowel obstruction and all of them had resection and primary anastomosis. Sixteen patients had gangrenous bowel obstruction of which 6 patients had resection-primary anastomosis and 10 had Hartmann’s procedure. Out of the total five deaths reported, there were only two among patients who had resection-primary anastomosis for gangrenous bowel obstruction. The commonest post-operative complication was surgical site infection in 5 cases (35.71%). The median length of hospital stay following surgery was 8 days (range 5 – 18 days). None of the patients had recurrences of volvulus after median follow up of 11 months.Conclusion Although Tunisia belongs to the volvulus belt, the epidemiologic features of sigmoid volvulus are not similar to those reported in the other African countries and tend rather to be similar to those of developed countries. Our results show that the absence of non-operative treatment can be tolerable and surgical management should be advocated as much as possible.

Sign in / Sign up

Export Citation Format

Share Document