Sigmoid Volvulus- A Series of 48 Cases
摘要
Purpose. The sigmoid colon is the most common site for colonic volvulus. It is a long redundant sigrnoid colon twisting on its mesenteric axis in either direction, leading to a closed loop obstruction. Sigmoid volvulus has variable geographical and racial distributions, mainly in developing countries and Scandinavia, but is of relatively low incidence in the Western and Eastern countries. The purpose of this study is to evaluate the characteristics and managing policy of the patients with sigmoid volvulus in a single hospital. Materials and Methods. This retrospective study recruits 48 patients with sigmoid volvulus treated at Taipei-Veterans General hospital (TVGH) during a 22-year period (from 1979 to 2000). There were 41 males and 7females.The mean age was 62.5 years old(ranged 9-88).The averaged follow-up period was 47 months, ranged between 6 months and 12 years. Results. Acute abdominal pain, abdomen distension, and constipation were the most frequent chief complaints. The diagnostic tools included KUB, barium enema, sonography and computing tomography (CT). There were34 patients receiving operative treatment, and 14 patients receiving non-operative treatment. In the surgical group, emergent operation was performed in 14 patients, elective surgery was performed in 20 patients, and only one surgical mortality was noted. Recurrence rate was 14%. Conclusion. Sigmoid volvulus is not common in Taiwan. The characteristic of patients in this area is more similar to West European and North America. This disease is a potentially lethal intestinal obstruction, especially when it involves elderly or institutionalized patients. The choice of treatment depends on the viability of colon. If there is no gangrene or perforation, initial decompression followed by elective surgery is recommended.