Emergency resection of sigmoid volvulus

Abstract

Objectives: To determine the outcome of emergency resection of sigmoid volvulus and to determine the factors associated with adverse outcome. Design: Retrospective case series review. Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Subjects: All cases of sigmoid volvulus operated at MTRH during the six years period between year 2000-2005. Main outcome measures: Mortality rate; morbidity rate; and duration of hospital stay. Results: Ninety two case files were analysed. Sigmoid volvulus accounted for 14.1% of all cases of intestinal obstruction and 80% of large gut obstruction. The mean age was 47.3 years and the median was 50 years. The range was 16 to 86 years. The male to female ratio was 29.3:1. Mortality was three (3.3%) cases and the morbidity was 20 (21.7%) cases. The mean duration of hospital stay was 11.8 days. Inadequate intravenous fluid therapy had a statistically significant adverse effect on outcome in this study. The yearly outcome remained unchanged during the six years of the study. Conclusions: Emergency resection in cases with a viable colon had a similar outcome to the traditional standard treatment by emergency endoscopic derotation followed by semi-elective or elective resection. The overall outcome was comparable to global standards. Inadequate postoperative intravenous fluid therapy significantly affected the outcome.