Usman Ali, Adnan Badar, Wajid Akbar, Israr.
A study of Sigmoid Volvulus Presenting to a Tertiary Care Hospital at Peshawar.
Ophthalmol Update Jan ;14(4):196-9.
Objective: Objective of the study was to enlist the various types of surgical management and postoperative complication of sigmoid volvulus in patients presented with sigmoid volvulus. METHODOLOGY: In this study a total of 38 patients with sigmoid volvulus coming to Accident & Emergency Department were included. All the patients were admitted and investigated. The diagnosis was based on x-ray erect abdomen. Blood complete, urea, sugar, S. Electrolysis, x-ray and ECG were also done. All the patients were catheterized and a nasogastric tube passed for gastric decompression. All the patients were rehydrated and prepared for surgery as facilities for colonoscopic sigmoidscopic decompression were not available and decompressions by rectal tube were unsuccessful. Results: Among the cases with sigmoid volvulus there were 26 (68.42%) males and 12 (31.58%) were females. Majority 18 (47.4%) cases were in age range of 61-70 years. Eight (21.05%) patients had gangrene of sigmoid colon, 15 (39.47%) patients had resection and colostomy while 15 (39.47%) had resection and primary anastomosis. Among the postoperative complications, 05 (13.15%) patients had wound infection and 01 (2.6%) wound dehiscence. Two (5.26%) patients died because of sepsis and cardiopulmonary complications. Conclusion: Patients presenting as acute abdomen should have urgent laparotomy as soon as possible. Colonoscopy is the gold standard procedure for stable patients with sigmoid volvulus. Sigmoidectomy and primary anastomosis is the procedure of choice as it not only avoids second admission and operation, but it also avoids the side effects and care of stoma which is major cause of morbidity.
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