Magnitude and Management Outcome of Sigmoid Volvulus in Tercha General Hospital, SNNPR, South Western Ethiopia

Abstract

Background: Sigmoid volvulus is the commonest cause of large gut obstruction in many regions of world including Pakistan India, Bengal and African countries. According to the few reports available in Northern and Central Ethiopia, sigmoid volvulus was the leading cause of IO. In the subocclusive group mortality was 35% and it increased up to 50% in those patients with a late diagnosis who underwent a sigmoid resection. Objective: The objective of this study is to assess the magnitude and management outcome of sigmoid volvulus in patients admitted with a diagnosis of sigmoid volvulus at Tercha General Hospital from January, 2012 to December 2016. Methods: A five year institutional based quantitative retrospective cross sectional study design done using data collecting from 113 patient’s medical card who were managed in Tercha General Hospital, Dawro zone, SNNPR region, Ethiopia with the diagnosis of Sigmoid volvulus. The collected data was checked for any inconsistencies, coded and fed in to Spss version 22 computer software for the analysis of the data. Results: The male to female ratio was 7.1:1.The ages range from between 36 and 80 years with a median and mean of 56 and 58.5 years. Sigmoid volvulus was the leading cause of obstruction in 113(40.2%) patients. Laparatomy was done for 52(46%) patients. Hartmans colostomy done in 15(13.3%). Length of hospital stay ranged from 3 – 21 days with a mean of 8.9 days. The commonest complications were wound infection 11(9.7%) and respiratory complications 8(7.1%). Complication and Mortality rates were 25.7% and 5.3% respectively. Conclusions and Recommendations: Sigmoid Volvulus is a commonly encountered condition of the surgical emergency procedures done for Intestinal Obstruction in our study. Conservative management with rectal tube deflation was associated with low mortality rate, in this series. Health facilities capable of handling patients with intestinal obstruction should be available within the reach of the community.