How far has the pendulum swung in the surgical management of sigmoid volvulus? Experience from the KwaZulu‐Natal Teaching Hospitals and review of the literature

Mnguni, M. N.; Islam, J.; Manzini, Vukani T.; Govindasamy, Vishendran; Zulu, B. M. W.; Clarke, Damian; Madiba, T. E.

doi:10.1111/j.1463-1318.2012.03046.x

Cited by 10 publications

(12 citation statements)

References 24 publications

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“…An uncomplicated sigmoid volvulus can be untwisted without opening the abdomen, by gently inserting a well-lubricated large rubber tube through an instrument (a proctoscope) inserted into the rectum. Overall survival should exceed 80 percent (Mnguni and others 2012;Nuhu and Jah 2010).…”

Section: Types Of General Surgical Emergenciesmentioning

confidence: 99%

General Surgical Emergencies

McCord

Ozgediz²,

Beard³

et al. 2015

Disease Control Priorities, Third Edition (Volume 1): Essential Surgery

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Acute abdominal conditions Incarcerated and Strangulated Inguinal Hernias Appendicitis Intestinal obstruction Complications of peptic ulcer, including perforated ulcer and bleeding ulcer Bleeding from esophageal varices Pelvic infections with abscesses Perforated typhoid ulcers Amebic liver abscess Gall bladder and bile duct disease Respiratory obstruction, foreign bodies, and pleural disease Urinary obstruction caused by stricture, stone, or prostatic enlargement Surgical infections of the skin, muscles, bones, and joints

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Section: Types Of General Surgical Emergenciesmentioning

confidence: 99%

General Surgical Emergencies

McCord

Ozgediz²,

Beard³

et al. 2015

Disease Control Priorities, Third Edition (Volume 1): Essential Surgery

View full text Add to dashboard Cite

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“…The non-resection procedures of sigmoidopexy and recto-sigmoidoplasty do not require bowel preparation with lower morbidity and mortality rates at first incidence. However, the recurrence rate is still very high, ranging from 45% to 71% [9] . Where a detorsion fails, and there are signs of colonic gangrene, sigmoid resection and Hartmanns' procedure with a temporary colostomy with a mucus spout would be done to avoid the high mortality associated with primary anastomosis in this situation [6,10] .…”

Section: Research Articlementioning

confidence: 99%

“…The mortality rate was twelve (30%) from various post-operative morbidities, especially peritonitis, septicemia, respiratory failure; Table 2. The rest died of consequences of multi-organ failures (MOF) [9] .…”

Section: Treatment Outcomementioning

confidence: 99%

Management of acute sigmoid volvulus in a tertiary hospital north central nigeria: The place of advanced radiodiagnostics

Oseni-Momodu

Shehu

Lee

2021

CSRC

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Background: Volvulus involves the twisting of an air-liquid stool-filled thin-walled segment of an intestine around its necessarily narrow mesenterial base, thereby strangulating the blood vessels, which often causes necrosis of this redundant intestinal segment. Intestinal volvulus had always been supposed to be a disease of the blacks from West African and the Bushmen natives of South Africa. The West African subset became the index region. Surgery was the best treatment for the full-blown disease. Conservative methods of management have only just been developed and studied in the Scandinavian countries. Scandinavian early rectosigmoidoscopic reductions of the twisted colonic segment have offered some valuable alternative helps. Methods: We studied the documents of all the 44 patients who had a presumptive diagnosis of acute or subacute colonic volvulus and were admitted to surgical management. Biostatistics, exact history taking of the patients, carefully structured physical examination, and a good digital scout X-ray investigation of the abdomen helped to make a rapid diagnosis. Laparotomies confirmed such a diagnosis. We did not regularly attempt to do recto-sigmoidoscopic untwisting of the volvuli. All had Hartmann’s procedure surgeries with terminal colostomies. Results: Of the 41 patients admitted to surgical management, 31 were males and 10 were females with a ratio of 3:1. The timing of surgery influenced mortalities and morbidities greatly. Conclusion: The diagnosis of acute volvulus was simple. We needed to record the medical history, took the proper physical examination, correctly explained the examination results, and only studied the abdominal X-ray film without resorting to advanced computer tomography.

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“…Mnguni et. al, [6] reported that SV predominately affected young African males and found that the timing of surgery, the type of anastomosis and the viability of the bowel did not influence surgical outcomes in 135 patients (122 males; with a mean age of 39.3 years; SD ± 17 years). Complications and mortality occurred in 14% and 17% of the study patients, respectively.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…A search through Medline, PubMed, Cinahl, and Ovid databases revealed that only16 reported SV studies were conducted in non-Western settings [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]25]. Only one of these studies examined lengths of stay (LOS) or sequelae associated with LOS and treatment.…”

Section: Review Of the Literaturementioning

confidence: 99%

Treatment of Sigmoid Volvulus by Deflation Versus Surgery: A Single Site Report

R¹,

Williams²,

Berhanu³

2015

Surgery Curr Res

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Background: Although very common in developing regions like Africa, sigmoid volvulus (SV) has a much lower incidence in the West. There is a dearth of literature on the treatment of SV in countries with limited resources. This paper reports study results using a cohort of 200 SV patients in a low-income developing country. Objectives:The aim of this study was to identify the characteristics associated with length of hospital stay (LOS) in the largest sample of sigmoid volvulus patients drawn from a single site within a single year and to examine the effects of treatment complications and previous attacks of SV on LOS.Methods: Data from charts for a retrospective sample of 200 adult SV patients hospitalized in 2012 at Gondar University Hospital, Ethiopia, were statistically analyzed to determine LOS by patient characteristics and the effects of complications on LOS.Results: Among the 200 patients diagnosed with SV, the ratio of deflation to surgery was almost 2:1 ratio to surgery. The total patient days in the study were 856 days. Patients with LOS > 5 days accounted for 79% of patient days. Patients with a maximum LOS of 30 days accounted for 10.5% of total patient days. The shortest LOS (1.36 days) was among patients who underwent sigmoidoscopic decompression only and had no treatment complications. Complications associated with surgery accounted for 10.6 to 17.0 LOS days. Age, gender, gangrene and previous attacks were not significantly associated with surgery. Among the study patients, there were only five cases of failed deflation followed by surgery. All but five of the patients with gangrene had surgery. Shock, stroke, abscess, sepsis and surgery significantly prolonged LOS. Patients (66%) had not experienced previous attacks. SV affected middle aged men more than the elderly men. Females had an excess relative risk (RR=1.62) for surgery but was not statistically significant due to the small number of females (n=15) in the study. Conclusion:Deflation was an effective treatment modality, while surgery was performed only when indicated and only on the critical cases. Patients who are treated with deflation may avoid surgery which can be associated with additional complications. Avoidance of surgery and complications can substantially reduce LOS with subsequent and system costs.

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How far has the pendulum swung in the surgical management of sigmoid volvulus? Experience from the KwaZulu‐Natal Teaching Hospitals and review of the literature

Cited by 10 publications

References 24 publications

General Surgical Emergencies

General Surgical Emergencies

Management of acute sigmoid volvulus in a tertiary hospital north central nigeria: The place of advanced radiodiagnostics

Treatment of Sigmoid Volvulus by Deflation Versus Surgery: A Single Site Report

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