A Study on Various Modalities of Surgical Management of Sigmoid Volvulus

Background: Worldwide incidence of sigmoid volvulus varies from 6-30%. In India the incidence varies from 11.8% in the west to 1.5 - 9.4 % in north and south India respectively, depending on the dietary constituents. The management of sigmoid volvulus varies depends on the timing of presentation and the condition of the large bowel.

Objective: The aim of the study was to evaluate the effectiveness of the various surgical options in treatment of sigmoid volvulus.

Methods: An analysis of 30 patients treated for sigmoid volvulus over a span of 1 year was done. The findings at exploration were carefully recorded. Following a suitable surgical procedure, the patients were monitored for complications and followed up.

Results: In our study of 30 patients, 23 were male, 7 female. The age group ranged from 20 - 70 years, with maximum patients in age of 60 -70 years. Majority of these patients presented with abdomen distension and abdomen pain followed by constipation and vomiting. Plain Skiagram was diagnostic in 90% patients. Operative procedure undertaken in 23 cases was primary resection and anastomosis whereas 5 cases were gangrenous Sigmoid Volvulus for which Hartmann's procedure was done.

Conclusion: This study showed that for non-gangrenous bowel, primary resection and anastomosis is ideal and for gangrenous bowel, Hartmann's procedure is ideal.