Treatment Outcomes of Sigmoid Volvulus Patients Admitted and Managed at Saint Paul’s Hospital Medical Millennium College

Abstract

Abstract Background: Sigmoid volvulus (SV) is one of the three most common causes of acute colonic obstruction and forms 50–90% of all colonic volvulus. Africa is named as one of the regions with high incidence and is included in ‘volvulus belt’. Different type of management was employed as definitive management but later WHO recommended decompression followed by elective surgery. Objectives: To assess outcomes for Sigmoid Volvulus among patients admitted for sigmoid colonic volvulus at Saint Paul`s Hospital Millennium Medical College (SPHMMC) from January 1st, 2012 to December 31st, 2017 G.C. Methods: The study was conducted in SPHMMC, department of Surgery from February 2018- April 2018. A retrospective hospital based study was conducted on all patients admitted from January 1st, 2012 to December 31st, 2017 G.C. in SPHMMC. The data was entered using Epi Info and analyzed using SPSS version 20 statistical software. Result: Majority 147 (89.0%) of the patients studied were male, making male to female ratio of 8; 1. From 165 patients with sigmoid volvulus who undergoes surgery 92% of the cases had shown favorable outcome. But, the remaining 8% of cases ended with unfavorable outcome, death. The age of patients ranges from 17 to 85yrs with a mean and SD 51.7 and 15.6 years respectively. From the Patients managed surgically; more than half 88 (53.7 %) went for resection & anastomosis on elective base. The rest 53 (32.3 %), 14 (7.9 %) and 10 (6.1 %) cases were managed by colostomy, derotation and primary repair on emergency base respectively. Conclusions and Recommendations: Low mortality rate is observed among surgically treated patients but patients stayed longer in the hospital. Significant number of patient’s had different types of post-operative complications like wound infection. A public awareness should be increased on the presenting symptoms of sigmoid volvulus through health education to reduce the late presentation, morbidity and mortality