Volvulus of the Sigmoid Colon - A Changing Approach in its Management

Volvulus of the Sigmoid Colon ranks high as a cause of acute abdomen in Africa. Often it leads to intestinal obstruction. The causes of this condition differ from region to region. In the western cultures, volvulus is a disease of the sixth decade The patients present with abdominal pain, distension, and absolute constipation. The predisposing factors include chronic constipation, mega colon, an excessively mobile colon, Parkinsonism and Psychiatric illness5. The African patient may be as young as 15 to 20 years and mainly has a redundant sigmoid colon. What place the diet plays is a matter that is still being debated4, 6. The golden standard of treatment has come to be as follows, decompression of the Sigmoid volulus with surgical action followed after 48 to 72 hours by resection and anastomosis. The stool is diverted using the Hartmans procedure or the Paul Mickulitz procedure. However, the golden standard is being challenged in favour of a one stage procedure. I present my opinion on this subject