Epidemiology, presentation, and outcomes of sigmoid volvulus in malawi: an 11-Year retrospective review

Abstract

Background: Sigmoid volvulus (SV) is a significant gastrointestinal condition in sub-Saharan Africa, although its epidemiology and outcomes are poorly understood. Objectives: To determine the prevalence, demographic characteristics, clinical presentation, and outcomes of SV in Malawi. Methods: An 11-year retrospective review of patients with SV at Queen Elizabeth Central Hospital, Malawi. Patient records were analysed for demographic characteristics, clinical presentation, mode of management, and outcomes. Results: We identified 301 cases of SV, with a prevalence of 27.3 cases per year. Males comprised 91.4% of cases, with a mean age of 51. Emergency presentations accounted for 69.8% of cases. Resection and primary anastomosis were the most common surgical procedures. The mortality rate was 11.3%, with non-viability of bowel being a significant predictor of mortality. Conclusions: SV contributes significantly to the disease burden, particularly among middle-aged males seen in the surgical department. It presents acutely, and resection and primary anastomosis are the primary surgical approaches. Non-viability of bowel was identified as a significant predictor of mortality, emphasising the need for prompt surgical intervention. Trial registration: Not Applicable.