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Sigmoid volvulus is the most-common form of volvulus of the gastrointestinal tract. ... If surgery is not performed, there is a high rate of recurrence. [10]
Sigmoid colon volvulus, also known as sigmoid volvulus, is volvulus affecting the sigmoid colon. It is a common cause of bowel obstruction [ 1 ] and constipation . It is common in Asia, India (7% of intestinal obstruction ) and especially South India because of the high fibre diet.
Patients with chronic, uncorrected or undiagnosed malrotation can have recurrent abdominal pain and vomiting. Malrotation may be asymptomatic. [2] Postnatal presentation occurs with indistinct symptoms which can include abdominal migraine or pain, recurrent vomiting, failure to thrive, weight loss and other non-specific gastrointestinal issues. [1]
Perforated diverticulitis often requires surgery due to risks of infection or recurrence. Recurrent diverticulitis may required resection even in the absence of perforation. Bowel resection or repair is typically initiated earlier in patients with signs of infection, the elderly, immunocompromised, and those with severe comorbidities. [16]
An ileosigmoid knot or compound volvulus is an uncommon cause of intestinal blockage. [1] The condition arises when ileum loops wrap around the bottom of a redundant sigmoid loop. [ 2 ] In some countries in Africa, Asia, and the Middle East, the ileosigmoid knot is a well-known ailment; this condition is uncommon in the West.
Benign indications for sigmoidectomy include diverticular disease, especially when complicated by perforation or fistulae, sigmoid volvulus, trauma, and ischemic or infectious colitis. [11] When a sigmoidectomy is followed by terminal colostomy and closure of the rectal stump; it is called a Hartmann operation .
Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, and constipation.Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischemia or perforation from prolonged distension or ...
Non-gangrenous ischemic colitis, which comprises the vast majority of cases, is associated with a mortality rate of approximately 6%. [34] However, the minority of patients who develop gangrene as a result of colonic ischemia have a mortality rate of 50–75% with surgical treatment; the mortality rate is almost 100% without surgical intervention.