Volvulus of Colon Sigmoide in the General Surgery Department of Chu Gabriel Toure

Abstract

Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1] . Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2] . Objective: To determine the hospital frequency of sigmoid colon volvulus; to write the clinical and para-clinical aspects of sigmoid colon volvulus; write down the different treatments used for the management of sigmoid colon volvulus . Material and methods: This was a retrospective and prospective study that took place from January 2008 to December 2020 in the General Surgery Department of Gabriel Touré. The retrospective phase ran from January 2008 to December 2019 and the prospective phase from January 2020 to December 2020. Results: From January 2008 to December 2020, we collected 320 cases of patients operated on for sigmoid colon volvulus out of 7989 surgical emergencies over a 12-year period, or 3.64%. In our study, the most represented age group was between 16 and 60 years old, i . e . 81.88%. The mean age was 42.6 ± 17.4 years with extremities of 16 and 90 years. The male sex was the most represented, 89% with a sex ratio of 8.41. The surgical history was found in 13.75% of our patients. The clinic was dominated by abdominal pain (100%), meteorism (100%), and gas and matter arrest (91.3%). The most common radiological image found in the ASP was the double jamb, i . e . 74.69% of cases. We found sigmoid necrosis in 18.13% of cases. We found an absence of necrosis in the majority of cases, i . e . 91.56%. The most performed operative procedure in our patients was the RACR, i . e . 75.63% of cases. The reoperation was performed in only 5.94% of our patients. Complications were grade V in 42.55% according to the Clavin Dindo classification.