Syed Nizamuddin, Sajida Qureshi, Shahriyar Ghazanfar.
Six years experience of Sigmoid Volvulus.
Pak J Surg Jan ;24(1):5-8.

Objective: To study the outcome of treatment in cases of Sigmoid Volvulus. Design & Duration: Retrospective analysis of case series from May 2000 to April 2006. Setting: Department of Surgery, Unit IV, Civil Hospital, Karachi. Patients: Sixty eight patients who were admitted with Sigmoid Volvulus during the study period. Methodology: The records of all the patients were reviewed retrospectively. Non-surgical methods like sigmoidoscopy, and barium, water soluble and saline enemata were tried in most of the cases to relieve obstruction. In patients with peritonitis or those with failure of non-surgical treatment, emergency surgery was performed. Results: The mean age of the patients was 58.1 years, and 89.7% of them were male. Amongst the patients 25% had a past history of similar episode, while 32.3% had co-morbidities. The mean duration of symptoms was 43 hours, and 14.8% of the patients were in shock. The most common clinical features were abdominal pain (98.7%), abdominal distension (96.0%), constipation (92.3%) and abdominal tenderness (98.7%). Correct clinical diagnosis was made in 80.6% of the cases, while abdominal X-rays revealed positive findings in 85.2% of the patients. X-rays of the abdo men in erect and supine position, ultrasound abdomen and sigmoidoscopy were used as diagnostic tools. Conclusion: Sigmoid volvulus is generally seen among adult males. Its major problems include a tendency to recurr, presence of co-morbidities and shock.

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