Clinical presentation, operative management, and outcomes of patients with sigmoid volvulus: A retrospective audit

Background: Surgical care of sigmoid volvulus (SV) is the main treatment and is tailored to the patient’s clinical presentation. The management and surgical outcomes of SV in our setup still remain variable, particularly in a setting with limited protocols and endoscopic management. Objective: To determine the clinical presentation, operative management, and outcomes of patients with SV. Methods: A retrospective audit of patients aged ≥13 years with SV from 2015 to 2023 was conducted. Results: The average age of patients was 45.6 years [standard deviation (SD) ±19.6], with 87.5% being male. The majority of patients were classified as American Society of Anesthesiologists physical status class I (66%). The mean duration of symptoms was 5.3 days. The majority (76.3%) had resection and primary anastomosis, while 23.8% had Hartmann’s procedure (HP). Fifty-five percent had viable bowel, while 45% had gangrenous bowel. The mean hospital stay was 14 days (SD ±8.7). Seventy-three percent of patients encountered complications, including surgical site infections (45%), anastomotic leaks (15%), and mortality (12.5%). Conclusion: Middle-aged men have a higher predilection for SV. Surgical resection with anastomosis remains the primary treatment for patients with viable bowel in the absence of endoscopic detorsion. HP had a higher mortality rate compared to primary anastomosis.