Management of sigmoid volvulus in the tropical area of Thies (Senegal)

• Published in: Médecine et santé tropicales (Montrouge, France) Vol. 25; no. 3; p. 316
• Main Authors: Ba, P A, Diop, B, Soumah, S A
• Format: Journal Article
• Language: French
• Published: France 01.07.2015
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Intestinal Volvulus - surgery; Male; Middle Aged; Retrospective Studies; Senegal; Sigmoid Diseases - surgery; Tropical Climate; Young Adult; Senegal; colon; intestinal obstruction; Senegal; sigmoid volvulus
• ISSN: 2261-2211
• DOI: 10.1684/mst.2015.0476

The aim of this study is to report our experience in the management of sigmoid volvulus in a tropical environment. This retrospective study covers the period from June 1, 2010, to December 31, 2013, in the department of emergency surgery at the regional hospital of Thiés: 40 patients were admitted with sigmoid volvulus: 36 men and 4 women, with a mean age of 45 years (20-89 years). Twelve had chronic constipation. All four signs of occlusion were present in 72.5% of cases. Abdominal radiography confirmed the diagnosis in all cases. The volvulus resolved spontaneously in one patient, while the other 39 required laparotomy: 25 had a one-stage colectomy, and 11 patients a sigmoidectomy with a temporary colostomy. Two patients underwent a sigmoidopexy, one with a simple closure of a perforated duodenal ulcer. The morbidity rate was 7.5%, due mainly to complications of infection. The mortality rate was 10%. After a mean follow-up of 2.77 months (range: 15 days-12 months), no recurrences were observed. Sigmoid volvulus is a common condition in Africa especially in younger patients. The diagnosis is easy, based on clinical and abdominal radiography findings. Several procedures have been described but the one-stage colectomy remains the method of choice, especially in tropical areas where socioeconomic conditions are difficult.