“Sigmoid volvulo: 5-year experience at the Rafael Hernandez Hospital. David, Chiriqui. January 2013-December 2018”

Abstract

ABSTRACT:

Introduction: The sigmoid volvulus is a common cause of intestinal obstruction on Andines areas, it could progress to bowel necrosis or perforation. Early diagnosis, ischemia level intestinal have direct influence on morbidity and mortality of patients. Exist a lack of information about the management of this pathology in our country.

Methods:  Observational study, descriptive, retrospective, since 2013 to 2018, with the objective of determine the patients characteristics that suffer from sigmoid volvulus, on the Rafael Hernandez Regional Hospital, evaluating epidemiological, clinical characteristics, laboratory exams, management and post-operative evolution.

Results:  Were attended 52 patients, of which 63.5% were older 60 years and 73.1% were male. 32.7% came from Comarcal regions (Indian reserve). Evolution time were 1 to 3 days in a 55.8% with clinical manifestations of abdominal pain, vomits and abdominal distention with 96.2%, 76.9% and 98.1% respectively. The coffee grain sign was present in 84.6% cases. Initial management was endoscopic in 53,6% and 46.2% cases required an urgent laparotomy. Every patient were operated and all were made sigmoid colon resections, the 63.5% were a Hartman procedure. Was reported only one fatality 1.9% and the hospital stay was more than 5 days on the 64.7% of cases.

Discussion:  The sigmoid volvulus represents the 10.4% of the causes of intestinal obstruction, it is more frequent in males over 60 years old and comarcal region (Indian reserve). The initial management was endoscopic, the procedure was a sigmoid colon resection in all cases, more frequent a Hartman procedure.