Various Modalities in the Management of Large Bowel Volvulus | ||
| Kerbala Journal of Medicine | ||
| Article 1, Volume 9, Issue 2, December 2016, Pages 2550-2556 PDF (0 K) | ||
| Authors | ||
| Amir Kareem Sultan; Sabah Kerim Al-husseiny; Jaber Mohsin Al-Goraby | ||
| Abstract | ||
| b ackground: Volvulus is twisting or axial rotation of a portion of bowel about its mesentery, colonic volvulus accounts for 10% to 30% of all large-bowel obstructions and occurs most commonly in the sigmoid colon. Aim of study: To clarify factors contribute to the problem (large intestinal volvulus) and how can we manage these factors in various modalities of surgical treatment. Patients and methods: A prospective study included (22) patients with large intestinal volvulus who were admitted to the emergency department and managed in the department of General Surgery, Baghdad Teaching Hospital Medical city, Iraq, during the period Oct. 2007 to Dec. 2009. In addition to demographic data, types of volvulus, and predisposing factors were identified. The diagnosis made according to the history, clinical features, and investigations; plain abdominal X-ray, hematological investigations and colonoscopy. Results: The mean age of the patients was 60.7± 23.4 (range 28-95) years. Males were 15/22 and females were 7/22. Sigmoid volvulus was the most common reported type in (91%) of the patients while cecum volvulus in the remaining (9%). The main presenting symptoms and signs were absolute constipation in 20 (91%) patients, generalized abdominal distension in 20 (91%), and abdominal pain and tenderness in 19 (86%) patients. Emergency surgery performed in (63.6%) of patients and the other (37.4%) were subjected to elective surgery. During surgery viable bowel was found in (19) patients (86%), while non-viable bowel was found in (3) patients (14%). Post-operative complications were detected in 4 patients (18%) and unfortunately one patient (4.5%) died. Conclusion: Volvulus of the colon is more frequent in males. Old age individuals seems to be the most affected group by sigmoid colon volvulus, Most cases can be treated conservatively, at first; by lower GIT endoscopy or by insert rectal tube to do reduction of colon then treated as elective definitive surgery after good preparation so can reduce the postoperative complications, in emergency surgery, if have viable bowel and stable patient we can do resection and primary anastomosis. | ||
| Keywords | ||
| Large Bowel; Volvulus; Management; Prospective study | ||
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