‘’TO ANALYSE THE RISK FACTOR, CLINICAL SIGNS AND SYMPTOMS, TREATMENT, COMPLICATIONS AND OUTCOMES OF SIGMOID VOLVULUS’’
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Keywords
Sigmoid colon, Strangulation, Volvulus, exploratory laparotomy, acute intestinal obstruction
Abstract
Background: Acute intestinal obstruction occurs when the forward flow of intestinal contents is interrupted or impaired by a mechanical cause. It is most commonly induced by intra-abdominal adhesions, malignancy, and herniation. Sigmoid volvulus is a condition in which the torsion of the sigmoid colon around its mesenteric axis leads to acute colonic obstruction that is not timely and properly treated, leading to life-threatening and morbid complications such as bowel ischemia, gangrene and perforation.
Aim- of the study is to analyse the risk factor, clinical signs and symptoms, treatment, complications and outcomes of sigmoid volvulus presents as a surgical emergency.
Methods: This is a prospective, single-centre, cohort study of 24 patients presenting to the hospital with features of acute intestinal obstruction in NSCB Medical college jabalpur from June 2021 to JUNE 2023. All data formulated in frequency charts.
Results: 21 patients (87.5%) were male and 3 patients (12.5%) were female. The age of the patients varied between 30-80 years, most of them between 50-70 years. The main risk factors were old age, male gender, rural residence, low socioeconomic status. The most common symptoms were absolute constipation and generalized abdominal distension followed by abdominal pain. The most common symptoms were tenderness followed by tachycardia and then fever. All patients were examined by clinical symptoms, plain X-ray of the upright abdomen and blood tests. most common site is small bowel obstruction [70%] followed by large bowel [30%] patients Vomiting, the most common postoperative complication, followed paralytic ileus. Among the patients, 6 had distended gangrenous bowel, 15 patients were found to have distended non-gangrenous, and 3 patients had perforated gangrenous bowel. Most patients were discharged, only 3 [12.8%] patients died.
Conclusions: intestinal obstruction, predominates in older men. Most patients with obstruction have a history of alcohol abuse, a high-fibre diet, and low socioeconomic status.
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Dr. Aafreen Syed
Department of General Surgery, Raipur Institute of Medical Sciences, Raipur
Dr Asif Ahmed Khan Abdullah
Department of General Surgery, Raipur Institute of Medical Sciences Raipur, Chhattisgarh
Dr Rishikesh Sinha
Department of General Surgery, Raipur Institute of Medical Sciences, Raipur, Chhattisgarh
Dr. Ankush lokhande
Resident, Department of General Surgery, NSCB, Jabalpur