Management of sigmoid colon volvulus: A Senegalese experience based on 73 cases

Abstract

Volvulus of the sigmoid colon is rare in the West, but is the main cause of colonic obstruction in developing countries. Diagnosis is based on clinical findings supplemented by standard unprepared abdominal X-rays (UPX). The aim of our study is to share our experience in the management of sigmoid colon volvulus in order to compare our results with those in the literature. We conducted a retrospective and descriptive study between 01 January 2008 and 31 December 2021. Our study included 73 patients admitted for sigmoid colon volvulus. The mean age of our patients was 48.8 years with extremes of 17 and 86 years. There were 62 men and 11 women, giving a sex ratio of 5.63. Chronic constipation was found in 63.01% (N=46), and occlusive syndrome concerned 100% of patients. An unprepared abdominal X-ray (UXR) was performed in 93.15% (N=68) of patients and showed a typical inverted U image in 100% of cases. Sigmoidectomy followed by restoration of digestive continuity was performed in 84.93% of cases. The average time taken to close the stoma was 21.8 days, with extremes of 15 and 49 days. Post-operative management was straightforward in 63 patients (86.30%). Morbidity in our series was 9.58%, i.e. 7 patients, and mortality was 3 patients, i.e. 4.10%.