EVALUATION OF THE OUTCOME OF VARIOUS OPERATIVE PROCEDURES IN ACUTE SIGMOID VOLVULUS – OUR EXPERIENCE.

Abstract

Volvulus is a condition in which a segment of the intestine twists on its own mesenteric axis and results in partial or complete obstruction. Increase in the intraluminal pressure of the bowel along with compromised blood supply leads to gangrene and perforation if unrelieved immediately. Sigmoid volvulus accounts for 2-3% of all intestinal obstructions. Even though it effects both sexes, males are more effected. Treatment differs based on the mode of presentation of volvulus. Relief of intestinal obstruction and resection of gangrenous sigmoid colon are the two main considerations. It is a surgical emergency condition and laparotomy is performed in all patients. Treatment can be divided into resection and nonresection procedures. Primary resection with end-to-end anastomosis is gold standard treatment for sigmoid volvulus. Sigmoid volvulus is more commonly seen in males when compared to females with high incidences in old aged around 5th and 6th decade of life. Procedures such as Sigmoidopexy are done in non-gangrenous and viable bowel conditions, while procedures such as resection and end-to-end anastomosis and Hartmann's procedures are done in cases with gangrene bowel, but carry a risk of mortality