Adult Sigmoid Volvulus in a Referral Hospital in East Africa

The purpose of this study was to report the presentation and management of a case of uncomplicated sigmoid volvulus in a referral hospital in East Africa. Sigmoid volvulus occurs due to twisting of the enlarged loop of the sigmoid colon about its mesenteric axis, resulting in acute colonic obstruction and eventual entrapment of the colon. A 46-year-old man had complained of his 7-day stomach pain, inability to defecate, and bloating. His abdomen was tympanic, distended and nontender. After his resuscitation, a laparotomy was performed, revealing volvulus of the sigmoid colon without intestinal ischemia or gangrene. A one-stage sigma colectomy and primary anastomosis were performed, and the patient recovered without complications. Endoscopic decompression is not available in East African emergency scenarios. Our patient underwent emergency laparotomy because he had a simple sigmoid torsion and no endoscopic torsion or rectal tube insertion. There was no morbidity after colon sigma resection and primary anastomosis. He recovered without complications. Single-stage sigma colectomy is reported to have a  mortality rate of 7.7% in East Africa. Septic shock is the leading cause of death in patients presenting with volvulus of the sigmoid colon. Early diagnosis and prompt treatment are necessary to  reduce morbidity and mortality in patients with intestinal obstruction due to volvulus of the sigmoid colon.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

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Keywords: Sub-Saharan Africa, sigmoid volvulus, morbidity, mortality, one-stage sigmoid colectomy

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