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ISSN 1727-897X (Electronic)

2013, Number 1

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Medisur 2013; 11 (1)

Management of Sigmoid Volvulus in Three General Community Hospitals of the Cuban Medical Mission in Bolivia

Estepa PJL, Santana PT, Estepa TJC

Language: Spanish
References: 14
Page: 37-44
PDF size: 153.28 Kb.


ABSTRACT

Background: Sigmoid volvulus is an emergency that occurs very frequently in the South American Andean area hospitals. It accounts for over 50% of all intestinal obstructions and still retains high mortality rates.
Objective: To characterize the management of sigmoid volvulus.
Methods: A prospective and descriptive study was conducted including all patients with sigmoid volvulus who attended three general community hospitals of the Cuban medical mission in Bolivia from June 2006 to June 2007 and were treated trough general surgery. We analyzed the following variables: age, sex, medical history, surgical diagnosis, classification and type of surgery, surgery performed, evolution, complications, use of antibiotic-prophylaxis and admission to intensive care units. The information was obtained from medical records, operative reports and a data collector model.
Results: Sigmoid volvulus occurred more frequently in the Yapacaní hospital, department of Santa Cruz; the predominant age group was that from 55 to 64 years old as well as the predominant sex was that of males. Chagas disease was detected in most of the patients studied. Among symptoms those that predominated were distension, abdominal pain and stool detention. Decompression, devolvulation and surgical treatment were the processes followed in all cases, being the Rankin-Mikulicz colostomy the most widely used. No patients underwent a second surgery, and there were no mortality rates.
Conclusions: Decompression, devolvulation and surgical treatment were the processes followed in all cases, being the Rankin-Mikulicz colostomy the most widely used. Most patients had a satisfactory evolution.


REFERENCES

  1. Márquez Hernández J, Noya Pimienta M, Hooker H. Propuesta alternativa para el tratamiento del vólvulo sigmoideo. AMC [revista en Internet]. 2010 [cited 15 Sep 2009]; 14 (1): [aprox. 18p]. Available from: http://scielo.sld.cu/scielo.php?pid=S1025-025520 10000100006&script=sci_arttext.

  2. Rodríguez Wong U, Badillo Bravo A, Cruz Reyes JM, Rovelo Lima E. Vólvulo de sigmoides en el Hospital Juárez de México: 20 años de experiencia. Revista Mexicana de Coloproctología. 2006 ; 12 (3): 112-6.

  3. Frisancho VO. Dolicomegacolon andino y vólvulos intestinales de altura. Rev Gastroenterol Perú. 2008 ; 28 (3): 248-57.

  4. Anand AC, Sashindran VK, Mohan L. Gastrointestinal problems at high altitude. Trop Gastroenterol. 2006 ; 27 (4): 147-53.

  5. Quevedo Guanche L. Vólvulo del sigmoides: diagnóstico y tratamiento. Rev Cubana Cir [revista en Internet]. 2007 [cited 15 Sep 2009]; 46 ( 3 ): [aprox. 2p]. Availablefrom: http://bvs.sld.cu/revistas/cir/vol46_3_07/cir16307. htm.

  6. Rodríguez-Loeches Fernández J, Pardo Gómez G. Enfermedades quirúrgicas del abdomen. In: García Gutiérrez A, Pardo Gómez G. Cirugía. La Habana: Editorial Ciencias Médicas; 2007. p. 1057-82.

  7. Anaya Kippes ME. Vólvulo de sigmoides, intubación recto sigmoidea descompresiva. Rev Méd (Cochabamba). 2009 ; 20 (3): 68-75.

  8. Irsula Ballaga V, Ojeda López LA. Vólvulo de sigmoides en la enfermedad de Chagas. MEDISAN [revista en Internet]. 2011 [ cited 18 Ago 2012 ] ; 15 (7): [aprox. 5p]. Available from: http://bvs.sld.cu/revistas/san/vol15_7_11/san177 11.htm.

  9. Alonso Araujo SE, Blanco Dumarco R, Figueiredo Bocchini S, Carlos Nahas S, Kiss DR, Cecconello I. Recurrence of chagasic megacolon after surgical treatment: clinical, radiological and functional evaluation. Clinic. 2007 ; 62 (1): 89-92.

  10. Safioleas M, Chatziconstantinou C, Felekouras E, Stamatakos M, Papaconstantinou I, Smirnis A, et al. Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly: a study of 33 cases. World J Gastroenterol. 2007 ; 13 (6): 921-4.

  11. Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Başoğlu M, Polat KI, et al. An Algorithm for the Management of Sigmoid Colon Volvulus and the Safety of Primary Resection: Experience with 827 Cases. Diseases of the Colon & Rectum. 2007 ; 50 (4): 489-97.

  12. Chiang LL, Lai HS, Ni YH, Hsu WM. Management of sigmoid volvulus based on Ladd´s procedure: a case report. Pediatr Neonatol. 2009 ; 50 (3): 129-31.

  13. Karavas A, Lee D, Mendel J, Hackford A. A novel interventional approach to sigmoid volvulus. European Journal of Radiology. 2008 ; 67 (2): e83-e6.

  14. Lepage-Saucier M, Tang A, Billiard JS, Murphy-Lavallée J, Lepanto L. Small and large bowel volvulus: Clues to early recognition and complications. Eur J Radiol. 2010 ; 74: 60-6.




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