Volvulus Acute of the Colonist Sigmoid to Mopti: Diagnostic and Therapeutic Aspects
- 1 Service of Surgery B, CHU Point G, Bamako, Mali
- 2 Service of General Surgery, Sominé Dolo of Mopti Hospital, Mali
- 3 Service of Surgery B, CHU Point G, Bamako, Mali
- 4 Service of Surgery B, CHU Point G, Bamako, Mali
- 5 Service of General Surgery, Sominé Dolo of Mopti Hospital, Mali
- 6 Service of Surgery B, CHU Point G, Bamako, Mali
- 7 Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology, Bamako, Mali
- 8 Service of Surgery B, CHU Point G, Bamako, Mali
- 9 Service of Surgery B, CHU Point G, Bamako, Mali
- 10 Service of General Surgery, Sominé Dolo of Mopti Hospital, Mali
- 11 Service of Anesthesia and Resuscitation, CHU Gabriel Touré, Bamako, Mali
- 12 Service of Neurology, CHU Gabriel Touré, Bamako, Mali
- 13 Service of Surgery B, CHU Point G, Bamako, Mali
Abstract
In 7 years, we brought together 100 cases of volvulus of the colon sigmoid to the hospital Sominé Dolo of Mopti among which the handle volvule was found without necrosis in 66 cases and necrosis 34 cases. Seventy-six patients benefited from a sigmoidectomy followed by a colorectal anatomize at a time, twenty one patients of an intervention of Hartmann. A surgical distortion was realized at 3 patients. All the patients operated by these last two techniques had a restoring of the digestive continuity for an average deadline of 90 days. The post-operative complications consisted of 11 cases of parietal suppuration and a case of evisceration. The average duration of follow-up was of 210 days. The post-operative mortality was 14%. It was about a state of toxic shock with visceral multi-failure (n = 13), and of a pulmonary embolism (n = 1). The treatment of the volvulus requires a fast diagnostic and therapeutic coverage. The best treatment consists of a resection of the sigmoid as a matter of urgency followed by an immediate anastomosis if the following conditions are carried achieved: state general voucher, experimented surgeon and if the resuscitation meadow, per and post-operative can be assured.
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