Emergency resection of sigmoid volvulus

Abstract

To determine the outcome of emergency resection of sigmoid volvulus and to determine the factors associated with adverse outcome. Retrospective case series review. Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. All cases of sigmoid volvulus operated at MTRH during the six years period between year 2000-2005. Mortality rate; morbidity rate; and duration of hospital stay. Ninety two case files were analysed. Sigmoid volvulus accounted for 14.1% of all cases of intestinal obstruction and 80% of large gut obstruction. The mean age was 47.3 years and the median was 50 years. The range was 16 to 86 years. The male to female ratio was 29.3:1. Mortality was three (3.3%) cases and the morbidity was 20 (21.7%) cases. The mean duration of hospital stay was 11.8 days. Inadequate intravenous fluid therapy had a statistically significant adverse effect on outcome in this study. The yearly outcome remained unchanged during the six years of the study. Emergency resection in cases with a viable colon had a similar outcome to the traditional standard treatment by emergency endoscopic derotation followed by semi-elective or elective resection. The overall outcome was comparable to global standards. Inadequate postoperative intravenous fluid therapy significantly affected the outcome.