VARIOUS SURGICAL OPTIONS FOR EMERGENCY MANAGEMENT OF SIGMOID VOLVULUS

Objectives: The objective of this study was to compare the outcome of various surgical options for theemergency surgical management of sigmoid volvulus.Methodology: This comparative study was conducted in emergency department of postgraduate medicalinstitute Lady Reading Hospital, Peshawar over a period of one year from February 2007 to January2008. Study comprised of hundred cases to have sigmoid volvulus on clinical and radiological groundsoperated in casualty department with various surgical options and outcomes of these procedures weredetermined postoperatively.Results: Out of 100 cases, 79% were males and 21% females. Majority 51% patients were in the age rangeof 41-60 years, 36% patients were in age group of 61-80 years. Resection and Hartman s procedure wasperformed in 52% cases, resection with primary anastomosis with covering colostomy in 18% cases,resection and primary anastomosis in 15% cases, and resection with double barrel colostomy (PaulMikulicz) in 15% cases. Wound infection/ dehiscence occurred in 21% cases, intra-abdominal abscess in9% cases, anastomosis leakage in 6% cases. Colostomy complications included bleeding in 7% cases,retraction in 7% patients, prolapse in 4% cases.Conclusion: Resection and Hartmann procedure was performed in majority of patients. Woundinfection/dehiscence, intra-abdominal abscess, anastomosis leakage were common postoperativecomplications with various frequencies..