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Médecine et Santé Tropicales

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Management of sigmoid volvulus in the tropical area of Thies (Senegal) Volume 25, issue 3, Juillet-Août-Septembre 2015

Authors
1 Département de chirurgie, université de Thiès, UFR des sciences de la santé, Ex l0e RIAOM - BP: 967 Thiès, Sénégal
2 Service de chirurgie centre hospitalier régional, 1 avenue Malick SY Prolongée, BP: 34 Thiès, Sénégal
3 Service de chirurgie, hôpital militaire de Ouakam, Dakar, Sénégal
4 Service de chirurgie, hôpital Saint Jean de DIEU de Thiès. BP 43A Thiès,
* Correspondance

The aim of this study is to report our experience in the management of sigmoid volvulus in a tropical environment. This retrospective study covers the period from June 1, 2010, to December 31, 2013, in the department of emergency surgery at the regional hospital of Thiés: 40 patients were admitted with sigmoid volvulus: 36 men and 4 women, with a mean age of 45 years (20-89 years). Twelve had chronic constipation. All four signs of occlusion were present in 72.5% of cases. Abdominal radiography confirmed the diagnosis in all cases. The volvulus resolved spontaneously in one patient, while the other 39 required laparotomy: 25 had a one-stage colectomy, and 11 patients a sigmoidectomy with a temporary colostomy. Two patients underwent a sigmoidopexy, one with a simple closure of a perforated duodenal ulcer. The morbidity rate was 7.5%, due mainly to complications of infection. The mortality rate was 10%. After a mean follow-up of 2.77 months (range: 15 days-12 months), no recurrences were observed. Sigmoid volvulus is a common condition in Africa especially in younger patients. The diagnosis is easy, based on clinical and abdominal radiography findings. Several procedures have been described but the one-stage colectomy remains the method of choice, especially in tropical areas where socioeconomic conditions are difficult.