AN EXPERIENCE OF SIGMOID COLON VOLVULUS AT EMMERGENCY WARD LRH

BACKGROUND: Sigmoid volvulus is a serious condition due to rotation of sigmoid colon. Volvulusoften presents with abdominal colic and distention. It can be managed conservatively by colonoscopicdecompression, followed by optimization of patient and finally surgical procedure. The present studywas based on the comparison of resection of sigmoid colon and double barrel colostomy or resection andprimary anastomosisOBJECTIVE: Objective of the study was to compare the results of primary anastomosis and colostomyin patients presenting with sigmoid volvulus.METHODOLOGY: In this study a total of 48 patients with sigmoid volvulus coming to Accident &Emergency Department were included. All the patients were examined and investigated. After diagnosisbased on x-ray erect abdomen all the patients were admitted in Accident and Emergency ward. Afteradmission Full Blood count, urea, sugar, S. Electrolysis and ECG were also performed. Patients werecatheterized and a nasogastric tube passed for gastric decompression. All the patients were givenintravenous fluids antibiotics and prepared for surgery as facilities for colonoscopic sigmoidscopicdecompression were not available and decompressions by rectal tube was unsuccessfulRESULTS: Among the cases with sigmoid volvulus there were 36 males and 12 were females. Majority28 cases were in age range of 61-70 years. Eight patients had gangrene of sigmoid colon, 23 patients hadresection and colostomy while 20 had resection and primary anastomosis. Among the postoperativecomplications, 05 patients had wound infection and 01 wound dehiscence. Two patients died because ofsepsis and cardiopulmonary complications.CONCLUSION: Patients presenting as acute abdomen should have urgent laparotomy as soon aspossible. Decompression by colonoscope is the gold standard procedure for stable patients with sigmoidvolvulus. Sigmoidectomy and primary anastomosis is the procedure of choice as it not only avoidssecond admission and operation, but it also avoids the side effects and care of stoma, which is majorcause of morbidity and mortality.