A STUDY ON SIGMOID VOLVULUS

Dr. A. Muthuvinayagam, Dr. V. Marimuthu

Abstract


Volvulus of the sigmoid colon is one of the commonest causes of large bowel obstruction.
The incidence of sigmoid volvulus is quite high in our country. Even though many literatures have come since the beginning of this century, our
knowledge about the disease, is still insufficient, particularly the etiology of this disease and the reasons for the difference in the clinical features of
the disease in the western countries compared to the east is still elusive.
There are many methods employed in the treatment of volvulus, each having its own merits and demerits, claims and counter claims by its own
advocates indicating that the exact management of this disease is far from clear.
50 cases, of sigmoid volvulus were admitted in our hospital from December 2001 to May, 2004.
Of these 50 cases, 3 cases came in a moribund condition and could not be resuscitated, and later went on against medical advice. 3 cases got
reduced spontaneously with soap and water enema.
44 cases underwent emergency surgery.
10 cases had viable bowel. Primary resection and anastamosis was done with a mortality rate of 20%. A more careful surgery would have reduced
the mortality to 10%.
34 cases had nonviable bowel. Of these, 5 patients underwent Hartmann’s procedure, 3 cases because of the bad state of the patient and 2 cases
because of technical difficulty in anastamosis giving a mortality and morbidity rate of 20% each.
29 patients with gangrenous bowel underwent resection and anastamosis with a mortality rate of 6.89% and a morbidity rate of 24.13%. The
morbidity rate was high in patients with surgical delay of more than 4 days than in patients with early intervention (28.5% Vs 9.7%) and a
preoperative blood urea level more than 40 mg% than with a lower blood urea level (42.9% Vs 12.9%).
AIM OF THE STUDY
1. To study the incidence of sigmoid volvulus in our region.
2. To study the etiological and epidemiological factors associated with this condition.
3. To review the various modalities of treatment available for sigmoid volvulus and to analyse the merits and demerits of each procedure.
4. To analyse the results of treatment, the mortality rate, morbidity rate and the recurrence rate and an attempt is made to find a solution to reduce
the same.
MATERIALS AND METHODS
All patients with the diagnosis of sigmoid volvulus by the admitting surgeon and those patients diagnosed preoperatively or peroperatively as a case
of sigmoid volvulus admitted between December 2017 and May 2018 were taken up for the present study.


Keywords


Teneligliptin, FRAP, Anti Oxidant Assay,nitric Oxide, Dpp4 Inhibitor, Ascorbic Acid

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References


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