Volvulus of the Sigmoid colon: pathogenesis and review of treatment

ABSTRACT

One hundred and ten patients [108 males and 2 females] with pelvic colon volvlus seen over a 4-year period [1973-1977] in the NWFP are presented. Emergency surgery was performed in 105 patients. Resection and primary anastomosis was employed in the first 12, nine of whom had nongangrenous and three gangrenous colons. The mortality in this group was six patients [50%]. Resection and double barrelled colostomy was employed in 70 patients [6] nonganrenous and 3 gangrenous colon] four [5.7%] of whom died. Hartmans procedure was used in 32 patients with gangrene involving the upper rectum as well as the pelvic colon. The mortality in this last group was patients [8.7%]. On the basis of these results, resection and double barreled colostomy and the Hartmam's operation are recomended as the procedure of choice in the emergency surgery of pelvic colon volvulus. Pathogens is discussed and a new concept is suggested to explain the high incidence of this condition during Ramazan and in the winter months