title: Emergency management of sigmoid volvulus--institutional experience over four years.
abstract: Sigmoid volvulus is a serious surgical emergency and a common cause of large bowel obstruction in India. Patients present with abdominal pain, distension and obstipation and abdominal skiagram usually reveals the characteristic omega sign. Non-operative detorsion with early elective sigmoidectomy is the procedure of choice where gut viability is not in doubt and features of peritonitis are absent. The objective of this study was to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Results revealed a high incidence of burst abdomen and anastomotic leak as well as a high mortality rate in patients undergoing resection with primary anastomosis without proximal colostomy. Mortality was least with Hartmann's procedure although there was a higher incidence of wound infection. Thus, in the hospital setting, we consider Hartmann's procedure to be the best emergency surgical procedure for sigmoid volvulus as it limits mortality to the least.
authors.affiliation: Department of General Surgery, NRS Medical College and Hospital, Kolkata 700014.
authors.forename: Tamal Kanti Sen
authors.initials: TK
authors.lastname: Gupta
authors.forename: Jayesh Kumar
authors.initials: JK
authors.lastname: Jha
authors.forename: Ravi Shankar
authors.initials: RS
authors.lastname: Biswas
authors.forename: Shankar Das
authors.initials: SD
authors.lastname: Chattopadhyay
authors.forename: Naveen Kumar
authors.initials: NK
authors.lastname: Gupta
authors.forename: Sushil
authors.initials: S
authors.lastname: Kumar
authors.forename: Nemai Chandra
authors.initials: NC
authors.lastname: Nath
authors.forename: Nisith Chandra
authors.initials: NC
authors.lastname: Karmakar
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004630:Emergencies; D005260:Female; D006801:Humans; D007194:India; D045822:Intestinal Volvulus / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012810:Sigmoid Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome