One Stop Management of Sigmoid Volvulus in an African Setting with Limited Resources

Abstract

Objective: To show the feasibility and safety of emergency resection of an unprepared redundant sigmoid colon and primary anastomosis.

Methods: A prospective study conducted at two Sudanese Hospitals, Nyala (Darfur) and Juba (South Sudan). Between January, 1st 2011 and December, 31st 2013, patients presenting with acute abdominal pain caused by large bowel obstruction were included on the study by two university firms.

Results: Thirty eight patients were included in the study; 33 were males and 5 were females. Of these, 9 patients were excluded at Laparotomy when the cause of their bowel obstruction was found to be due to small bowel obstruction and colonic tumour. Therefore, 29 patients were legible for the study. Of these 29 patients, 3 were females and 26 males with mean age (48), and range (22-75) years. All 29 patients at Laparotomy had redundant sigmoid colon resected. 4 (4/29) ended up with a Hartmann’s procedure and 25/29 underwent redundant sigmoid colectomy and primary anastomosis. Post-operatively 6/29 had wound infections and none had a documented anastomotic dehiscence.

Conclusion: This series shows the feasibility and safety of management of large bowel obstruction caused by sigmoid volvulus by an emergency one stop resection and primary anastomosis

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