Ainul Hadi, Nadim Khan, Syed Murad Ali Shah, Adil Bangash.
Emergency management of sigmoid Volvulus: experience of Lady Reading Hospital Peshawar.
J Postgrad Med Inst Jan ;20(1):82-5.

Objective: To know the outcome of resection and end to end anastamosis with defunctioning colostomy in patients with sigmoid volvulus, operated in emergency. Material and Methods: This study was conducted from Jan 2004 to December 2004 at surgical "C" unit Post Graduate Medical Institute Lady Reading Hospital Peshawar. Patients presenting to emergency department with clinical suspicion of sigmoid volvulus, were thoroughly examined and underwent baseline and radiological investigations before surgery. Final diagnosis was made per operatively and emergency resection and end to end anastamosis with defunctioning colostomy were performed in all patients in casualty operation theatre. Results: During the time period, 25 diagnosed patients with sigmoid volvulus were finally selected for the study. Seventeen patients (68%) were in their 5th and 6th decades of life. Male to female ratio was 11.5:1. In 24 operated cases (96%), the gut was viable while in one case the gut was gangrenous. The average length of stay was 7-days. Mortality was 4% (one case), which was attributed to pre-operative unstable condition and gangrenous gut at the time of surgery. Conclusion: Resection of sigmoid colon with primary anastamosis and a proximal defunctioning colostomy is a safer procedure in inexperienced and learning hands in emergency situations.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com