Adult Sigmoid Volvulus in a Referral Hospital in East Africa

Abstract

The purpose of this study was to report the presentation and management of a case of uncomplicated sigmoid volvulus in a referral hospital in East Africa. Sigmoid volvulus occurs due to torsion of a dilated loop of sigmoid colon around its mesenteric axis resulting in acute colonic obstruction and eventually colonic strangulation.
A 46-year-old male presented with a seven-day history of stomach pain, inability to pass stool, and flatus. His abdomen was tympanic, bloated, and nontender. Following resuscitation, a laparotomy was conducted, which revealed sigmoid volvulus with no bowel ischaemia or gangrene. A one-stage sigmoid colectomy and primary anastomosis was carried out and the patient made an uneventful recovery.
Endoscopic decompression is not available in the emergency scenario in East Africa. Our patient was brought for an emergency laparotomy since he had straightforward sigmoid volvulus and no endoscopic detortion or rectal tube insertion. There was no morbidity following sigmoid colectomy and primary anastomosis. He made an uneventful recovery. One-stage sigmoid colectomy was reported to have a 7.7% mortality rate in East Africa. Septic shock is the leading cause of death in people who present to the hospital with sigmoid volvulus. To reduce morbidity and mortality in a patient with sigmoid volvulus bowel obstruction, an early diagnosis and prompt care are required.