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.

Experience of transcatheter device closure of atrial septal defect in a tertiary care institute

2021 ◽  
pp. 1-12
Author(s):  
Muhammad Younas ◽  
Ahsan Beg ◽  
Tauseef Asma ◽  
Baqir Maqbool
Keyword(s):  
Pericardial Effusion ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Tertiary Care ◽  
Safe Procedure ◽  
Device Closure ◽  
Cross Sectional ◽  
Female Ratio ◽  
Transcatheter Device ◽  
Small Pericardial Effusion

Abstract Objective: To share our experience of transcatheter device closure of secundum atrial septal defect in children and adults. Methods: This descriptive cross-sectional study was conducted at department of Paediatric Cardiology Ch. Pervaiz Elahi Institute of Cardiology Multan from 2011 to September 2019. Patients with moderate to large ASD secundum without severe pulmonary hypertension were studied. All procedures were performed under general anaesthesia and trans-Oesophageal echo guidance. Success and safety of procedure were evaluated. Results: During study period, a total of 75 patients underwent ASD device closure. Mean age was 25 ± 1.53 (4 -54 years) and male to female ratio 1:2. Mean defect was 20.38 ± 0.58 (09 to 32 mm). Large defects (> 25 mm) were 17 (22.7 %). Significant PS (> 30 mm Hg) observed in three and valvuloplasty performed. Device size was selected on the basis of TOE measurement + 4-5 mm. Balloon sizing was performed in only three patients. Amplatzer   septal occluder was used in 80 %. Balloon assisted technique was used in 09 (12 %) patients. All the procedures were successful except two (2.7 %) where device embolized and retrieved by surgery. Transient arrhythmias were observed in 05 (6.6 %) and small pericardial effusion which was managed conservatively in one patient. There was no procedure related mortality. Conclusion: Transcatheter closure of moderate to large ASD secundum in children and adults is a safe procedure. Among the major events, device embolizaion was common. Other complications were rare including small pericardial effusion and transient arrhythmias. Continuous...

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

scholarly journals A clinical study on the management of sigmoid volvulus

2017 ◽  
Vol 4 (3) ◽  
pp. 1039
Author(s):  
M. Ramula Durai ◽  
J. Kiran Kumar ◽  
. Vijayanand
Keyword(s):  
Tamil Nadu ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
Primary Resection ◽  
Safe Procedure ◽  
Management Options ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Primary Resection And Anastomosis

Background: Sigmoid volvulus is a surgical emergency and significant cause of large bowel obstruction with high mortality and morbidity. The disease is more prevalent in India, especially rural population. It constitutes 15% of total bowel obstructions. This study analyzes various management options in our institute which caters mainly to patients from the surrounding rural areas.Methods: The present work is study of 36 cases, carried out as regards to the etiological factors which predispose to the sigmoid volvulus, the clinical features, modes of treatment and the outcome. Particular stress has been laid on the various treatments. The duration study was 2 years between November 2014 and October 2016 at Government Chengalpattu medical college, Tamil Nadu, India.Results: The mean age of sigmoid volvulus was 49 years (range 19-75) and male to female ratio was 2:1. Comparatively less frequent in less than 20 years and above 70 years. Distention of abdomen (100%), followed by constipation in 88% were common mode of presentation. Sigmoidopexy done in 22% patients with nil mortality and, for primary resection and anastomosis, it was 17%. Common post-operative complication found to be wound infections.Conclusions: Primary resection anastamosis is found to be definitive safe procedure if the colon is viable. Hartman’s procedure is suitable only if the bowel is gangrenous. Absence of co morbid conditions a notable feature. Pre operative X-RAY helpful in diagnosis. Mortality found to be 17.5% in our study.

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.

The Twisted Colon: A Review of Sigmoid Volvulus

2020 ◽  
Vol 23 (2) ◽  
pp. 90-94
Author(s):  
ABM Khurshid Alam ◽  
Masfique Ahmed Bhuiyan ◽  
Hasnat Zaman Zim ◽  
Tapas Kumar Das
Keyword(s):  
Sigmoid Colon ◽  
Emergency Surgery ◽  
Primary Anastomosis ◽  
Flexible Endoscopy ◽  
Sigmoid Resection ◽  
Primary Treatment ◽  
Sigmoid Volvulus ◽  
Laboratory Findings ◽  
Operative Findings ◽  
Resection And Anastomosis

In sigmoid volvulus (SV), the sigmoid colon wraps around itself and its mesentery. Sigmoid volvulus accounts for 2% to 50% of all colonic obstructions and has an interesting geographic dispersion. SV generally affects adults, and it is more common in males. The etiology of sigmoid volvulus is multifactorial and controversial; the main symptoms are abdominal pain, distention, and constipation, while the main signs are abdominal distention and tenderness. Routine laboratory findings are not pathognomonic: Plain abdominal X-ray radiographs show a dilated sigmoid colon and multiple small or large intestinal air-fluid levels, and abdominal CT and MRI demonstrate a whirled sigmoid mesentery. Flexible endoscopy shows a spiral sphincter-like twist of the mucosa. The diagnosis of sigmoid volvulus is established by clinical, radiological, endoscopic, and sometimes operative findings. Although flexible endoscopic detorsion is advocated as the primary treatment choice, emergency surgery is required for patients who present with peritonitis, bowel gangrene, or perforation or for patients whose non-operative treatment is unsuccessful. Although emergency surgery includes various non-definative or definitive procedures, resection with primary anastomosis is the most commonly recommended procedure. After a successful nonoperative detorsion, elective sigmoid resection and anastomosis is recommended. The overall mortality is 10% to 50%, while the overall morbidity is 6% to 24%. Journal of Surgical Sciences (2019) Vol. 23(2): 90-94

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 Indications and outcomes of tracheostomy in intensive care unit

2020 ◽  
Vol 6 (8) ◽  
pp. 1430
Author(s):  
Mukhlesur Rahman ◽  
Mahmuda Begum ◽  
Mujibul Hoque Khan ◽  
Mostsfa Mahfuzul Anwar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cross Sectional Study ◽  
Anterior Wall ◽  
Safe Procedure ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College ◽  
Life Threatening

<p><strong> </strong></p><p class="abstract"><strong>Background:</strong> Tracheostomy is a commonly performed surgical procedure in the intensive care unit (ICU) in which creation of a stoma between the skin and the anterior wall of the trachea where there is need for prolong mechanical ventilation. Tracheostomy has considered a safe procedure in ICU but has been found to lead to life threatening complications intra and post operatively.</p><p class="abstract"><strong>Methods:</strong> This is a cross sectional study, was carried out in ICU, Chittagong Medical College Hospital, Chattogram from January 2018 to December 2019. A total of 120 patients irrespective of age and sex whose tracheostomy has done after admission in ICU by ENT surgeons.  </p><p class="abstract"><strong>Results:</strong> Out of 120 patients maximum 34 (28.33%) were from 21-30 years age group and male to female ratio was 1.79:1, male patients were 77 (64.16%) and female patients were 43 (35.83%). The most common indication for tracheostomy in ICU was head injury and history of RTA 34 (28.33%) followed by post-operative case of intracranial space occupying lesion 30 (25%). Post tracheostomy complication was surgical emphysema 4 (3.33%). The rate of complication of tracheostomy in ICU was 10.83% in this study. Regarding benefits of tracheostomy over endotracheal tube in ICU, we found that 100% patients had greater comfort.</p><p class="abstract"><strong>Conclusions:</strong> Tracheostomy in ICU is an important and safe procedure if prolonged endotracheal in tubation is advised for varying underlying causes.</p>

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