COLORECTAL CARCINOMA;

Introduction: Large bowel obstruction due to colorectal carcinoma occurs in up to 20% of the patients and usually2-4 accompanied by morbidity and mortality . Almost 25 % deaths occur post-operatively following surgery for colorectal cancers occur in1 those who initially present with obstruction . Usually elderly patients with associated co-morbidities presents with bowel obstruction.Objective: Find out the frequency of colorectal cancers in patients presenting with large bowel obstruction. Design: Prospective crosssectional study. Setting: Shaikh Zayed Hospital Lahore. Period: from 31st December 2010 to 31st December 2012. Materials &Methods: A total 20 patients were presented with large bowel obstruction with the age ranges between 40 to 70 years. All the 20 patientsunderwent routine haematological and biochemical tests. In these patients an abdominal x-ray in a supine or standing position was takenand dilated loops of bowel, air-fluid interfaces, or both was observed then Contrast radiography(Barium/gastrograffin) was done todefine the site and extent of the obstruction. An abdominal computed tomography scan was done to evaluate the extent of the disease.Colonoscopy was also carried out in the patients with colorectal cancers to find out the size and location of the tumor and biopsy taken bycolonoscope. Results: 12 patients out of 20 presented with large bowel obstruction were diagnosed to have a colorectal cancers and theage ranges from 60 to 70 years. The 8 patients were diagnosed to have a sigmoid colonic tumour and 4 patients were suffering from atumour of recto sigmoid junction. Whereas in rest of the 8 patients the large bowel obstruction was due to other benign causes likevolvulus and intussusception and age range was 50 – 60 years. 6 patients were suffering from sigmoid volvulus and remaining 2 hadcolo-colic intussusception. Conclusions: It is concluded that the major cause of the large bowel obstruction is the left sided colorectalcancers the tumours of recto sigmoid junction.

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Magnitude and Clinical characteristics of Sigmoid Volvulus

10.21203/rs.3.rs-29801/v1 ◽

2020 ◽

Author(s):

Atalel Fentahun Awedew ◽

Bedemariam Tadesse Amsalu ◽

woldemariam Beka Belay ◽

Dawit Zerihun Yalewu

Keyword(s):

Logistic Regression ◽

Hospital Stay ◽

Bowel Obstruction ◽

Large Bowel ◽

Clinical Characteristics ◽

Statistical Significance ◽

Large Bowel Obstruction ◽

Sigmoid Volvulus ◽

Outcome Variable ◽

The Mean

Abstract Background: Sigmoid volvulus is a major cause of mechanical large bowel obstruction in volvulus belt countries. The objective of this study to explore the magnitude and clinical characteristics of Sigmoid Volvulus Methods: Hospital-based retrospective cross-sectional study employed in Debre Tabor general hospital Northcentral Ethiopia. A medical review conducted on the medical chart from Jan1, 2016 to Dec31, 2019. The collected data checked manually for completeness and consistency. The final data coded and entered to SPSS version 23 for data processing and analysis. Binary logistic regression used to measure the association of each covariate with the outcome variable. In addition, factors that have p=0.25 with the outcome variables were taken into a multivariable logistic regression analysis to control the potential confounders. The result of the final model expressed in terms of adjusted Odd Ratios (AOR) and 95% CI and statistical significance declared if the P-value is less than 0.05.Result: There were 124 patients with sigmoid volvulus admitted within four years of the study. During the study period, 408 patients with bowel obstructions were admitted, among Mechanical large bowel obstruction (MLBO) 135 (33.1%), Mechanical small bowel obstruction (MSBO) 251(61.5%), and Ileosigmoid knotting 22(5.4%). Our study showed that sigmoid volvulus accounted for 91.9% and 30.4% of Mechanical Large bowel obstruction and Bowel obstruction respectively. Most of the patients were male 97.6 %( N=121) and rural residents 91.1 %( N=113). The peak age was 56-65 years accounted for 29 % and 65.3 %( N=81) of patients were above age 50years. The age ranged from 19-88 years. The mean and median ages were 56.52± (SD=14.4) and 58.5± (IQR=17.75) respectively. The mean of hospital stay for elective admission was 10.98(SD±4.33) days and the median was 11 (IQR±5) days. The mean of hospital stay for emergency admission excluding death and leave against medical advice was 8.4(SD±4.1) days and median was 8 (IQR±2) days Conclusion: Primary resection and anastomosis was the common procedure for management of sigmoid volvulus. Mortality rate was 6.45% and higher in gangrenous sigmoid volvulus (14.6 % vs. 2.4%)

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Magnitude and Clinical characteristics of Sigmoid Volvulus

10.21203/rs.3.rs-29801/v2 ◽

2020 ◽

Author(s):

Atalel Fentahun Awedew ◽

Bedemariam Tadesse Amsalu ◽

woldemariam Beka Belay ◽

Dawit Zerihun Yalewu

Keyword(s):

Logistic Regression ◽

Hospital Stay ◽

Bowel Obstruction ◽

Large Bowel ◽

Clinical Characteristics ◽

Statistical Significance ◽

Large Bowel Obstruction ◽

Sigmoid Volvulus ◽

Outcome Variable ◽

The Mean

Abstract Background: Sigmoid volvulus is a major cause of mechanical large bowel obstruction in volvulus belt countries. The objective of this study to explore the magnitude and clinical characteristics of Sigmoid Volvulus Methods: Hospital-based retrospective cross-sectional study employed in Debre Tabor general hospital Northcentral Ethiopia. A medical review conducted on the medical chart from Jan1, 2016 to Dec31, 2019. The collected data checked manually for completeness and consistency. The final data coded and entered to SPSS version 23 for data processing and analysis. Binary logistic regression used to measure the association of each covariate with the outcome variable. In addition, factors that have p=0.25 with the outcome variables were taken into a multivariable logistic regression analysis to control the potential confounders. The result of the final model expressed in terms of adjusted Odd Ratios (AOR) and 95% CI and statistical significance declared if the P-value is less than 0.05. Result: There were 124 patients with sigmoid volvulus admitted within four years of the study. During the study period, 408 patients with bowel obstructions were admitted, among Mechanical large bowel obstruction (MLBO) 135 (33.1%), Mechanical small bowel obstruction (MSBO) 251(61.5%), and Ileosigmoid knotting 22(5.4%). Our study showed that sigmoid volvulus accounted for 91.9% and 30.4% of Mechanical Large bowel obstruction and Bowel obstruction respectively. Most of the patients were male 97.6 %( N=121) and rural residents 91.1 %( N=113). The peak age was 56-65 years accounted for 29 % and 65.3 %( N=81) of patients were above age 50years. The age ranged from 19-88 years. The mean and median ages were 56.52± (SD=14.4) and 58.5± (IQR=17.75) respectively. The mean of hospital stay for elective admission was 10.98(SD±4.33) days and the median was 11 (IQR±5) days. The mean of hospital stay for emergency admission excluding death and leave against medical advice was 8.4(SD±4.1) days and median was 8 (IQR±2) days Conclusion: Primary resection and anastomosis was the common procedure for management of sigmoid volvulus. Mortality rate was 6.45% and higher in gangrenous sigmoid volvulus (14.6 % vs. 2.4%)

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Large bowel obstruction due to colorectal carcinoma can be safely treated by colonic stent insertion - case series from a UK district general hospital

Colorectal Disease ◽

10.1111/j.1463-1318.2012.03035.x ◽

2012 ◽

Vol 14 (12) ◽

pp. 1489-1492 ◽

Cited By ~ 8

Author(s):

P. Blake ◽

R. Delicata ◽

N. Cross ◽

G. Sturgeon ◽

R. Hargest

Keyword(s):

Colorectal Carcinoma ◽

General Hospital ◽

Bowel Obstruction ◽

Large Bowel ◽

Case Series ◽

District General Hospital ◽

Large Bowel Obstruction ◽

Stent Insertion ◽

Colonic Stent

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Pediatric sigmoid volvulus of an extremely long sigmoid colon with hypoganglionosis: a case report

Journal of International Medical Research ◽

10.1177/03000605211032429 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110324

Author(s):

Matjaž Horvat ◽

Marko Hazabent ◽

Marjan Sekej ◽

Milka Kljaić Dujić

Keyword(s):

Sigmoid Colon ◽

Bowel Obstruction ◽

Large Bowel ◽

Treatment Options ◽

Vascular Occlusion ◽

Abdominal Distension ◽

Large Bowel Obstruction ◽

Sigmoid Volvulus ◽

History Of

Sigmoid volvulus is an extremely rare cause of intestinal obstruction in pediatric patients. This condition occurs when a redundant sigmoid loop with a narrow mesenteric base of attachment to the posterior abdominal wall rotates around its mesenteric axis. This situation might result in vascular occlusion and large bowel obstruction. There are only a few predisposing factors of sigmoid volvulus, such as a long-term history of constipation or pseudo-obstruction with an excessive sigmoid colon. Underlying hypoganglionosis can also lead to large bowel obstruction. There have only been two reported cases of hypoganglionosis with sigmoid volvulus, and both were in adults. Sigmoid volvulus usually presents with abdominal pain, nausea, vomiting, constipation and abdominal distension, an absence of stool, or the presence of melenic stool in the rectum. Initial treatment options are non-surgical for stable patients, although surgical management might be necessary. If sigmoid volvulus is not recognized and resolved, it may lead to serious complications and death. Pediatric sigmoid volvulus is frequently the fulminant type, and therefore, a decision about treatment must be prompt. We present an unusual pediatric case of an extremely long sigmoid colon with hypoganglionosis, which twisted and caused obstruction. This condition was resolved with surgical resection.

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