Management of sigmoid volvulus in the tropical area of Thies (Senegal)

Bâ, P. A.; Diop, Bernard Marcel; Soumah, Sékou Amadou

doi:10.1684/mst.2015.0476

Cited by 4 publications

(7 citation statements)

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“…Spontaneous detorsion is possible but rare. It is found in the literature in 2 to 3% of cases [2,22] . In our series, it was observed in 1.47% of cases.…”

Section: Discussionmentioning

confidence: 96%

Adult sigmoid volvulus in West Africa: Management and outcome at principal hospital of Dakar

Egpa¹,

Faye²,

Ndiaye³

et al. 2021

Int. J. Surg. Sci.

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Background: Sigmoid volvulus (SV) is the commonest cause of large bowel obstruction in sub Saharan Africa. However few studies have been done in our country. Our goal was to describe the presentation, management outcome of adult SV and to evaluate our therapeutic methods in a context of non availability of endoscopic decompression. Methods: It was a retrospective, descriptive review of all adult patients, admitted in the visceral surgery department of Hospital Principal of Dakar for SV, from January 2014 to August 2018. We studied demographics variables, clinical and paraclinical features, treatment and outcome. The data were entered and analyzed using Excel 2017 software and Epi-info version 7.2.2.6. Results: We collected 103 cases of SV for 86 patients, representing 45.9% of intestinal obstruction. The mean age was 54.9 years. There were 82 males and 4 females. The mean duration of symptoms was 3.8 days. The triad acute abdominal pain, inability to pass gas and feces, abdominal meteorism was noted in 52.4%. Plain abdominal X-ray (n=55; 53.3%) showed the classical 'coffee bean' sign in 69%. CT scan (n=77; 74.7%) confirmed the diagnosis in 100%. It revealed signs of intestinal gangrene in 8 cases confirmed at laparotomy in 6 cases. In 4 cases imaging was not performed. Detorsion was spontaneous in 2 cases. Faucher rectal tube decompression was performed in 81 cases with a success rate of 86.4% representing 53 patients. Elective sigmoidectomy was realized in 33 patients (31 after successful rectal tube decompression, 2 after spontaneous decompression). After elective sigmoidectomy mortality and morbidity were nil. In those with successful rectal tube decompression, 7 did not have elective sigmoidectomy for comorbidities, 12 refused the elective sigmoidectomy. Emergency surgery was performed in 34 patients: 20 patients for suspicious of complicated SV, 14 patients after failure of rectal tube decompression. It was 9 (26.4%) one stage sigmoidectomy, 24 (70.5%) 2 stage sigmoidectomy, 1 surgical detorsion without pexy. Mortality and mortality after emergency surgery were respectively 8.3% and 14.7%. After 2 stage sigmoidectomy, 86.3% benefited from a restoration of digestive continuity. During the follow-up, no recurrence occurred in patients who were operated. Conclusion: SV is a middle-age man pathology in sub Saharan Africa. In uncomplicated SV rectal tube decompression followed by elective sigmoidectomy is a good option.

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“…Spontaneous detorsion is possible but rare. It is found in the literature in 2 to 3% of cases [2,22] . In our series, it was observed in 1.47% of cases.…”

Section: Discussionmentioning

confidence: 96%

Adult sigmoid volvulus in West Africa: Management and outcome at principal hospital of Dakar

Egpa¹,

Faye²,

Ndiaye³

et al. 2021

Int. J. Surg. Sci.

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“…with sigmoid volvulus, 14% of all patients with sigmoid volvulus. In the series by Ba et al, 30% of patients with sigmoid volvulus had a history of chronic constipation [14]. Surgical history was reported in 52.2% of patients.…”

Section: Epidemiological Considerationsmentioning

confidence: 94%

“…This rate is much closer to that found in the study carried out by Gomis in 2017 [1] with 47.5% for a duration of evolution of 3.6 days. Ba et al [14] found a rate of 72% for a mean evolution time of 2.5 days. This suggests that the longer the mean duration of signs, the higher the rate of complete occlusive syndromes.…”

Section: Diagnosismentioning

confidence: 95%

“…Vomiting was very frequent in our study, with a rate of 74.2%. In fact, vomiting is more precocious when the zone is proximal and the mechanism is strangulation [17] dies by Soumah [14], who found 85% respectively. Ooko et al [6] reported a similar rate of 78%.…”

Section: Diagnosismentioning

confidence: 99%

“…However, the study by Baer et al in 2017 [30] showed that there was no particular difference between the morbidity and mortality of stenting and those of colonic surgery. The stent also enables colonic preparation to be carried out, so that colonic surgery can be performed under better local conditions and colostomy, which is generally poorly tolerated due to certain socio-cultural beliefs, can be avoided [14] [30].…”

Section: Therapeutic Treatmentmentioning

confidence: 99%

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Management of Acute Bowel Obstruction in Adults in Ziguinchor Hospital Establishments: About 163 Cases Followed Up

Sow,

Badji,

Dieng

et al. 2024

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Acute intestinal obstruction represents a very frequent admission to surgical emergencies. The aim of our study was to make a descriptive analysis of the management of acute intestinal obstructions at the level of hospital establishments in Ziguinchor. Materials and Methods: This was a retrospective, descriptive, multicenter study from the period of January 1, 2017 to December 31, 2021. Patients over 15 years of age admitted for occlusive syndrome in the two surgical departments of the Ziguinchor regional hospitals were included in the study. Epidemiological, diagnostic, therapeutic and evolutionary data were studied. Results: Acute intestinal occlusions accounted for 8.3% of admissions. A total of 163 patients were enrolled, 61.9% were men, sex ratio of 1.6. The mean age was 48.7 years. The average consultation time was 74.8 hours (3.12 days). The total occlusive syndrome was in 48.5% of the cases. Abdominal pain was present in 87.1%, vomiting in 74.2%, cessation of matter and gas in 60.7% and meteorism in 36.2%. Biological lab tests reported hyperleukocytosis in 28.1% of the cases. Abdominal CT scans were performed in 71.2%, confirming the diagnosis in 90.5% and determining the etiology in 93.1%. The zone of the obstruction in the small bowel was 62.7%, and in the colon in 37.3%. Functional occlusions accounted for 22.7% of cases and mechanical for 77.3%, including 120 cases of strangulation occlusion (95.2%) and 6 cases of obstruction. Etiologies were dominated by adhesions and/or fibrous bands (61.2%). Medical treatment resolved the occlusive syndrome in 9.2% of cases, instrumental treatment in 17.1% and surgical treatment in 77.3%. Adhesiolysis/section of fibrous bands (55.7%), detorsion (14.3%) and resection + anastomosis (11.9%) were the most common surgical procedures.

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