Abstract:
BACKGROUND: Sigmoid volvulus is the commonest cause of large bowel obstruction in many
regions of the world. Its prevalence varies greatly geographically. In Ethiopia, the disease is the
commonest cause of emergency admissions due to intestinal obstruction. However, few studies
have been conducted in North West and central part of the country in general; there was no study
in Mettu particularly.
Objective: To assess the pattern & management outcome of acute sigmoid volvulus at MKRH,
oromia region, south west Ethiopia.
METHOD: A facility based retrospective cross sectional review of surgical records was
obtained. Data was collected with structured questioner by three pre trained data collectors. The
collected data were checked for its completeness, entered, edited, cleaned and analyzed using
Statistical Package for the Social Sciences (SPSS) version 22.0. For all statistical significance
tests the cutoff value set is P<0.05.
Result: one hundred thirty one patients were managed non-operatively &operatively for acute
sigmoid volvulus, of which108 (82.4%) were male patients (Male to female ratio of 4.7:1). The
Hospital prevalence of acute sigmoid volvulus was 27.9%. Abdominal pain, abdominal
distention & inability to pass feces & flatus were invariably the main presenting compliant in
131 (100%) of patients and abdominal distention was the dominant physical finding in
131(100%) of those patients. Those patients who had viable bowel was 97(74%) & gangrenous
bowel was 34(26%). Primary resection & anastomosis was done for 78/131(59.5%) and followed
by Hartman’s colostomy 18/131 (13.7%). The case fatality rate of patients after primary
resection & anastomosis 6.4%.Factors associated with poor outcome were female sex (p-.025),
primary resection and anastomosis (p-.020) and duration of illness (p-.027). The predominant
postoperative complication was wound infection in 13/102(12.7%).
Conclusion & Recommendation
The Hospital prevalence was 27.9% and mortality rate of acute sigmoid volvulus4.5%.
The most common management option was primary resection & end to end anastomosis.
Increasing referral linking and community awareness for early medical seeking behavior
