Prise en charge des volvulus du côlon pelvien en milieu rural : à propos de 42 cas colligés au Centre Hospitalier Régional de Ziguinchor (Sénégal)

Abstract

The purpose of this work was to assess the results of the management in rural area of pelvic colon volvulus.We conducted a retrospective study at
Ziguinchor Regional Hospital over a period of 4 years from January 2015 to december 2018. The study population was consisted of 36 men and 6
women with a mean age of 47 years. Six patients had a history of chronic constipation. The bowel obstruction syndrome was complete in 54.76%.
Plain abdominal x-ray was performed in 90% of cases and CT-scan in 2 patients. Two patients had an elective colectomy after a blind Faucher probe
untwisting, and 39 patients had a midline laparotomy. The intestinal loop was viable in 60% of cases and necrotic in 40% of cases. A segmental
resection associated with a colostomy according to Bouilly-Volkmann was the most performed procedure (47.6%) and the ideal colectomy in 38%
of cases. Four patients had surgery according to Hartmann’s procedure. The meantime before colostomy take down was 29 days [20-90 days]. Surgical follow-up was unevent ful in 83% of cases (n=35). Post-operative mortality was 4.7% (n=2) secondary to sepsis and hypovolemic shock. The
Pelvic colon volvulus is a surgical emergency frequent in Africa, especially in young male adult. Even if, the bowel obstruction syndrome and plain abdominal x-ray are the elements of the positive diagnosis, abdominal CT-scan is important to assess the severity. Elective sigmoidectomy is the traitment of choice.

Keywords: Sigmoid colon volvulus, colectomy, emergency, rural area.