Gangrenous Sigmoid Volvulus – A Case Report with review of literature

Abstract

Sigmoid volvulus is a life threatening surgical emergency which demands early surgical intervention. The condition is prevalent all over the world. Both sexes can be involved but more common in males. Mostly it is a disease of elderly males but can occur in neonates to young individuals. The condition presents in two distinct form gangrenous and non gangrenous sigmoid volvulus. Gangrenous volvulus is associated with high morbidity. Volvulus patient presents with pain, distension of abdomen and absolute constipation. Plain X-ray erect abdomen will give us definite diagnosis. In doubtful cases double contrast barium enema will clinch the diagnosis. In non gangrenous sigmoid volvulus sigmoidopexy either by endoscopic or open surgery is the procedure of choice. Otherwise sigmoid resection with end to end anastomosis is a definite treatment of choice. In gangrenous sigmoid volvulus, Hartmann procedure with end colostomy is the safe and life saving procedure. We had a case of gangrenous sigmoid volvulus presented with pain, distension and absolute constipation with toxic symptoms. After taking X-ray erect abdomen the case was diagnosed as volvulus sigmoid. Hartmann's procedure was done after patient was resuscitated. Patient recovered well and discharged with a plan to close the colostomy after two months. We wish to present this case because it is a life threatening condition, death is certain if not treated early. We reviewed the literature regarding type of treatment since every surgeon is having his own line of approach to the problem.