Factors affecting bowel gangrene development in patients with sigmoid volvulus.

Abstract

BACKGROUND AND OBJECTIVESSigmoid gangrene develops in 6.1% to 93.4% of sigmoid volvulus (SV) cases, and increases the mortality rate from 0% to 40% without bowel gangrene to 3.7% to 80%. This study aimed to investigate factors that induce bowel gangrene development in SV patients.DESIGN AND SETTINGSRetrospective study from a single center.PATIENTS AND METHODSWe determined whether there was any correlation between sigmoid gangrene and the following factors: age, gender, a previous history of a volvulus, previous history of abdominal surgery, pregnancy, major comorbidities, shock, duration of symptoms, direction and degree of rotation of volvulus, and ileosigmoid knotting.RESULTSOf 442 patients, 271 (61.3%) had sigmoid gangrene. The presence of pregnancy was negatively correlated with sigmoid gangrene development (P<.05), while comorbid diseases (P<.01), associated shock (P<.01), prolonged symptom duration (P<.05), overrotation (P<.05), and associated ileosigmoid knotting (P<.01) were positively correlated with bowel gangrene. However, no correlation was observed between sigmoid gangrene and the other studied factors.CONCLUSIONAn inverse correlation between pregnancy and sigmoid gangrene was observed. On the other hand, a positive correlation was noted between bowel gangrene and comorbid diseases, shock, prolonged duration of symptoms, overrotation, and associated ileosigmoid knotting.