VARIOUS SURGICAL OPTIONS FOR EMERGENCY MANAGEMENT OF SIGMOID VOLVULUS

Munir Ahmad, Shahid Alam, Saeed Amer, Nadim Khan, Liaqat Ali Shah, Muzafar Ud din Sadiq, Nasir Ahmad

Abstract


Objectives: The objective of this study was to compare the outcome of various surgical options for the
emergency surgical management of sigmoid volvulus.
Methodology: This comparative study was conducted in emergency department of postgraduate medical
institute Lady Reading Hospital, Peshawar over a period of one year from February 2007 to January
2008. Study comprised of hundred cases to have sigmoid volvulus on clinical and radiological grounds
operated in casualty department with various surgical options and outcomes of these procedures were
determined postoperatively.
Results: Out of 100 cases, 79% were males and 21% females. Majority 51% patients were in the age range
of 41-60 years, 36% patients were in age group of 61-80 years. Resection and Hartman's procedure was
performed in 52% cases, resection with primary anastomosis with covering colostomy in 18% cases,
resection and primary anastomosis in 15% cases, and resection with double barrel colostomy (Paul
Mikulicz) in 15% cases. Wound infection/ dehiscence occurred in 21% cases, intra-abdominal abscess in
9% cases, anastomosis leakage in 6% cases. Colostomy complications included bleeding in 7% cases,
retraction in 7% patients, prolapse in 4% cases.
Conclusion: Resection and Hartmann procedure was performed in majority of patients. Wound
infection/dehiscence, intra-abdominal abscess, anastomosis leakage were common postoperative
complications with various frequencies.

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