These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Management of sigmoid volvulus].
    Author: Ghariani B, Houissa H, Sebai F.
    Journal: Tunis Med; 2010 Mar; 88(3):163-7. PubMed ID: 20415188.
    Abstract:
    AIM: The objective of this work paper is to report our experience in the management of the sigmoid volvulus. METHODS: This retrospective study relates to 40 cases of sigmoid volvulus operated in Surgical Departments B of Rabta University Hospital, Tunis, from January 1999 to December 2008. It refers to 35 men and 5 women, of 55 years as average age. Twenty six patients have been subjected to a volvulus removal through rectosigmondoscopy, which allowed a untwisting of the volvulus in 23 cases. Those patients have been subjected to a colorectal anastomosis within an average 9 day term. Among those patients, 5 subjects have undergone a sigmoidectomy assisted by laparoscopy. Urgent laparotomy has been performed in 17 patients following failure or complication of the endoscopy (3 cases), or straightaway laparotomy (14 cases) which showed a colic necrosis in 10 cases, of which 4 cases had stercoral peritonitis. One patient had a pre perfrorative lesions on right colon has been subjected to a total colectomy, followed by an ileorectal anastomosis. A sigmoidectomy has been performed in 16 patients, followed by a colorectal anastomosis (n = 2), an Hartman intervention (n = 4) and a double stomy (n = 10). All those patients have had restoration of digestive continuity within an average 90 days term. RESULTS: Postoperative complications have consisted in 5 pneumopathy cases, 2 heart insufficiency cases, 3 urinary tract infection cases and on peristomial eventration case. No patient has showon an anastomotic loosening or a recurrence after elective surgery. The average follow-up duration was 110 days. Four deaths have occurred immediately after urgent laparotomy. This relates to a state of septic shock with multiple organ failure (n = 2), a lung embolus (n = 1) and a pneumapatty (n = 1) CONCLUSION: The best treatment for sigmoid volvulus consists to an endoscopic volvulus removal intervention followed by a sigmoidal resection during the same hospitalization period. Urgent laparotomy is indicated in case of signs of necrosis or failure of endoscopy. Sigmoidal resection without immediate restoration of digestive continuity is recommended in presence of risk factors of anastomotic loosening.
    [Abstract] [Full Text] [Related] [New Search]