Abstract
Sigmoid volvulus (SV) is the wrapping of the sigmoid colon around its mesentery, and sigmoid gangrene is a catastrophic complication of SV. Although the diagnosis of SV is generally not difficult, unfortunately, most of the clinical, laboratory and radiological signs are not pathognomonic in demonstrating sigmoid gangrene. The treatment of gangrenous SV requires emergency surgery. Sigmoid gangrene worsens the prognosis of SV by doubling the mortality rate.
Highlights
Sigmoid gangrene is seen in 6.1-93.4% of cases with sigmoid volvulus (SV).[1,2]
Some clinical and laboratory findings such as melanotic stool, fever, leucocytosis, abdominal guarding/rebound tenderness, hypotension/shock, somnolence and metabolic acidosis suggest the sigmoid gangrene, most of them generally fail in accurate diagnosis.[3,4]
We wanted to utilize the present data and experience to evaluate the comorbidity of SV with sigmoid gangrene
Summary
Sigmoid gangrene is seen in 6.1-93.4% of cases with sigmoid volvulus (SV).[1,2] some clinical and laboratory findings such as melanotic stool, fever, leucocytosis, abdominal guarding/rebound tenderness, hypotension/shock, somnolence and metabolic acidosis suggest the sigmoid gangrene, most of them generally fail in accurate diagnosis.[3,4] some radiological studies including Doppler ultrasonography, angiography. Assistant Professor, 1-3: Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey. Despite SV being rare worldwide,[3] it is relatively common in Eastern Anatolia,[9] where we live. Our clinic has approximately 52 years of history and 1,008 cases of experience with SV, which is the largest single-centre SV series over the world.[10] We wanted to utilize the present data and experience to evaluate the comorbidity of SV with sigmoid gangrene. In our 1,008-case SV series, sigmoid gangrene was determined in a total of 284 patients (28.2%). Sigmoid gangrene is generally limited to the twisted segment or a few cm. From the proximal and distal lines, but it rarely extends. To the descending colon or rectum, only occurring in patients with very late admission, over-rotation or ileosigmoid knotting
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