Gangrenous sigmoid volvulus: a clinical study of 76 patients

Abstract

This study identified three risks for survival. It is suggested that all patients with nongangrenous sigmoid volvulus undergo a recurrence-prevention procedure immediately or electively. We also found that extension of gangrene beyond the confines of the constriction is not uncommon, calling for caution on the part of the treating surgeon.

Retraction

“…In SV cases, previous SV episode or detortion experiences, and associated severe diseases have always been the prevalent features, as was in the present series. [1][2][3][4][5]8,9 Late admission is generally a problem in SV because of the presence of associated diseases and different defecation habits. 1,4,5 In our opinion, it is also related to socioeconomic problems in developing or underdeveloped countries, as was in our series.…”

“…Presence of rectal melanotic stool or rebound tenderness and muscular defense may show gangrene or perforation and peritonitis. [1][2][3][4][7][8][9][10] In our belief, in an endemic region, the presence of a triad of colic abdominal pain, asymmetrical distention and obstipation in a patient over 40 years of age is highly significant in diagnosing SV.…”

Gangrene of Large Bowel Due to Volvulus-Etiopathogenesis, Management and Outcome

“…The predominant symptom of gangrenous sigmoid volvulus is abdominal pain and progressive abdominal distension (92 to 95%), constipation (92%), muscle guarding / rigidity (75%) and vomiting in 60% of the cases (Asbun 1992, Bagarani 1993, Bhatnagar 2004, Oren 2007, Pahlman 1989. A visible sigmoid loop is noted in 42% and rectal examination may reveal blood in the examination finger.…”

“…A visible sigmoid loop is noted in 42% and rectal examination may reveal blood in the examination finger. The median duration of symptom on admission is 3 days (3.7±2.8 range 1-15) (Asbun 1992, Bagarani 1993, Bhatnagar 2004, Oren 2007, ,Pahlman 1989. A previous attack of volvulus is recorded in 23.5% while 72.5% may develop gangrene in the first attack (Bhatnagar 2004).…”

“…The median duration of symptom on admission is 3 days (3.7±2.8 range 1-15) (Asbun 1992, Bagarani 1993, Bhatnagar 2004, Oren 2007, ,Pahlman 1989. A previous attack of volvulus is recorded in 23.5% while 72.5% may develop gangrene in the first attack (Bhatnagar 2004). The incidence of preoperative shock did not differ in patients with differing pattern of gangrene but the incidence of shock is significantly higher in patient who died (Bagarani 1993 …”