Acute sigmoid volvulus in a West African population

Abstract

Acute sigmoid volvulus in The Gambia is almost exclusively a male disease. Sigmoid colectomy and primary anastomosis can be carried out safely in those with viable colon without on-table colonic lavage.

Review of Sigmoid Volvulus: A 5 Years Experience in Tertiary Care Hospital, Visakhapatnam

“…14,22 The non resectional procedures such as sigmoidopexy and mesosigmoidoplasty have lower morbidity and mortality rates but have high incidence of recurrence. 22 Where the decompression fails and there are signs of colonic gangrene, sigmoid resection and Hartmann's procedure or double barrelled colostomy is done to avoid the high mortality associated with primary anastomosis in this situation. 22,23 Recently laparoscopic resection has been used in high-risk or elderly patients who may not tolerate conventional surgery.…”

“…22 Where the decompression fails and there are signs of colonic gangrene, sigmoid resection and Hartmann's procedure or double barrelled colostomy is done to avoid the high mortality associated with primary anastomosis in this situation. 22,23 Recently laparoscopic resection has been used in high-risk or elderly patients who may not tolerate conventional surgery. 23 A more critical appraisal is however needed for its general use.…”

Sigmoid volvulus in young patients: Ą new twist on an old diagnosis

“…In the first, a sigmoid resection and Hartman's procedure or a doublebarreled colostomy is performed in order to avoid a high rate mortality with primary anastomosis in that situation. In the second stage 6-8 weeks later, Hartman's procedure is reversed or the colostomy is closed (30,31).…”

Management of Sigmoid Volvulus Avoiding Sigmoid Resection

“…The management of SV can be classified into nonsurgical and surgical treatment and includes endoscopic detorsion followed by elective resection, if there is no suspicion of bowel ischemia or perforation [5, 6, 7, 8, 9, 10]. Nonoperative techniques, such as decompression through colonoscopy, can convert an emergent procedure in a mentally prepared and medically optimized patient to a semi-elective procedure.…”