Management of Acute Sigmoid Volvulus in a Tertiary Hospital North Central Nigeria: The Place of Advanced Radiodiagnostics

Abstract

Background: Volvulus involves the twisting of an air-liquid stool-filled thin-walled segment of an intestinearound its necessarily narrow mesenterial base, thereby strangulating the blood vessels, which often causesnecrosis of this redundant intestinal segment. Intestinal volvulus had always been supposed to be a disease ofthe blacks from West African and the Bushmen natives of South Africa. The West African subset became theindex region. Surgery was the best treatment for the full-blown disease. Conservative methods of managementhave only just been developed and studied in the Scandinavian countries. Scandinavian early rectosigmoido-scopic reductions of the twisted colonic segment have offered some valuable alternative helps.Methods: We studied the documents of all the 44 patients who had a presumptive diagnosis of acute or sub-subacute colonic volvulus and were admitted to surgical management. Biostatistics, exact history taking of thepatients, carefully structured physical examination, and a good digital scout X-ray investigation of the abdomenhelped to make a rapid diagnosis. Laparotomies confirmed such a diagnosis. We did not regularly attempt todo recto-sigmoidoscopic untwisting of the volvuli. All had Hartmann’s procedure surgeries with terminal co-lostomies.Results: Of the 41 patients admitted to surgical management, 31 were males and 10 were females with a ratioof 3:1. The timing of surgery influenced mortalities and morbidities greatly.Conclusion: The diagnosis of acute volvulus was simple. We needed to record the medical history, took theproper physical examination, correctly explained the examination results, and only studied the abdominal X-ray film without resorting to advanced computer topography

Management of acute sigmoid volvulus in a tertiary hospital north central nigeria: The place of advanced radiodiagnostics. Available from: https://www.researchgate.net/publication/354958199_Management_of_acute_sigmoid_volvulus_in_a_tertiary_hospital_north_central_nigeria_The_place_of_advanced_radiodiagnostics