%0 Journal Article
%T The sigmoid volvulus: surgical timing and mortality for different clinical types
%A Roberto Cirocchi
%A Eriberto Farinella
%A Francesco La Mura
%A Umberto Morelli
%A Stefano Trastulli
%A Diego Milani
%A Micol S Di Patrizi
%A Barbara Rossetti
%A Alessandro Spizzirri
%A Ioanna Galanou
%A Konstandinos Kopanakis
%A Valerio Mecarelli
%A Francesco Sciannameo
%J World Journal of Emergency Surgery
%D 2010
%I BioMed Central
%R 10.1186/1749-7922-5-1
%X We realized a retrospective clinical study including all the patients treated for sigmoid volvulus in the Department of General Surgery, St Maria Hospital, Terni, from January 1996 till January 2009. We selected 23 patients and divided them in 2 groups on the basis of the clinical onset: patients with clear clinical signs of obstruction and patients with subocclusive symptoms. We focused on 30-day postoperative mortality in relation to the surgical timing and procedure performed for each group.In the obstruction group mortality rate was 44% and it concerned only the patients who had clinical signs and symptoms of peritonitis and that were treated with a sigmoid resection (57%). Conversely none of the patients treated with intestinal derotation and colopexy died. In the subocclusive group mortality was 35% and it increased up to 50% in those patients with a late diagnosis who underwent a sigmoid resection.The mortality of patients affected by sigmoid volvulus is related to the disease stage, prompt surgical timing, functional status of the patient and his collaboration with the clinicians in the pre-operative decision making process. Mortality is higher in both obstructed patients with generalized peritonitis and patients affected by subocclusion with late diagnosis and surgical treatment; in both scenarios a Hartmann's procedure is the proper operation to be considered.A volvulus is an abnormal twisting of the bowel on its mesenteric axis greater than 180 degrees [1], which produces an obstruction of the intestinal lumen and mesenteric vessels. Only a satisfactorily long mesenteric axis, as in the case of sigmoid colon, allows this torsion. The predisposing factors for the sigmoid volvulus are indeed the length of the sigmoid colon and the colon distension due to chronic constipation. The trigger factor causing the twisting of the sigmoid colon, maximally distended by the faecal impaction in constipated patients, is a quick emptying of the terminal faecal column por
%U http://www.wjes.org/content/5/1/1