Sigmoid Volvulus Due Chagas Disease

Abstract

American Trypanosomiasis, also known as Chagas disease, is a parasitic disease caused by Trypanosoma cruzi and transmitted by hematophagous vectors, occupies the fourth place as a cause of loss of potential years of life between infectious and parasitic diseases, and has an acute presentation form and chronic, in which it can present complications at cardiac and digestive levels, among others. The development of megacolon with subsequent development of volvulus is an important cause of acute abdomen and intestinal obstruction that requires urgent treatment, as it presents an axial rotation of the intestinal loop with obstruction in a closed loop and subsequent ischemia. According to the World Health Organization, there are between 16 and 18 million infected people in the world, of which the majority is located in Latin American territory, and it is estimated that approximately only 1% receives adequate diagnosis and complete treatment.

Hospitalizations due to gastrointestinal Chagas disease: National registry

“…Moreover, with the reduction of the vector transmission resulting from successful interventions in the 80s and 90s, due to a cohort effect, CD in Brazil became predominantly a disease of the elderly [ 25 ]. Although less frequently, we found hospitalized patients in younger age groups, as seen in other studies [ 26 ]. It is possible that, at least in part, these cases are due to vertical transmission [ 27 ].…”

Digestive Disorders in Chagas Disease: Megaesophagus and Chagasic Megacolon

“…American trypanosomiasis ranks as the fourth most frequent disease-causing loss of productive years [1]. Also known as Chagas disease, this disease is a parasitic infection transmitted by hematophagous vectors [2] and is characterized by an acute period with general symptoms, which leads to a chronic phase and the development of complications at different levels of the infected organism.…”

“…The reports, made by the World Health Organization (WHO), mention that in the world there are between 16 and 18 million infected people which approximately only 1% receives an early diagnosis and full treatment, being the area with the highest incidence is in the Latin American area where this infection is considered endemic. Due to the public health implications and the high percentage of complications that it presents in chronic phases, the Pan-American organization and the World Health Organization consider this disease as the most serious parasitic infection in Latin America [1].…”

“…Although the development of complications associated with the chronic stages of Chagas diseases, such as intestinal volvulations [3] in megacolon, is relatively uncommon in Western countries, it is still considered the most severe complication [4], positioning itself as the third cause of lower intestinal obstruction in some countries, only below diverticular disease and colon cancer [1]; with respect to megaesophagus, complications can occur even in patients who are considered asymptomatic, who nevertheless present motor disorders of the esophagus that can lead to the development of neoplasms.…”