Emergency one-stage resection without mechanical bowel preparation for acute sigmoid volvulus

Abstract

The traditional staged operation for acute sigmoid volvulus is giving way to one-stage resection. Similarly, the conventional requirement for bowel cleansing is being increasingly questioned. In this report, we reviewed the outcome of our management over a ten-year period. There were 24 patients aged 23-100 years. Of these, 21 had one-stage primary resection with no clinical anastomotic leak and only one wound infection and fascial dehiscence. The two deaths from this group were due to respiratory failure in a patient aged 100 years and overwhelming sepsis in a younger patient with bowel gangrene from ileosigmoid knotting. We conclude that emergency one-stage resection for acute sigmoid volvulus without mechanical bowel preparation is safe.

Keywords: Sigmoid volvulus, bowel preparation, primary resection, anastomosis

Journal of Medicine and Biomedical Research Vol. 3 (1) 2004: pp. 86-90