TITLE:
Recurrent Sigmoid Volvulus after Sigmoidectomy: 3 Clinical Cases
AUTHORS:
Murielle Etiennette Julie Note Madzele, Didace Massamba Miabaou, Pierlesky Elion Ossibi, Moïse Service Yanguedet, Noé Henschel Motoula Latou, Prude Pertinie Avala, Giresse Bienvenu Tsouassa Wa Ngono, Meddi Bhodého Monwongui, Carmich Nzaka Moukala
KEYWORDS:
Recurrent Volvulus, Sigmoid, Sigmoidectomy
JOURNAL NAME:
Surgical Science,
Vol.14 No.12,
December
21,
2023
ABSTRACT: Introduction: Recurrent sigmoid volvulus is a medical and
surgical emergency. It is the recurrence of a twisting of the sigmoid loop
around its mesenteric axis initiating an occlusion by strangulation. The risk
factors of colonic volvulus are: a dolichosigmoid, a chronic constipation, a
tumor, …In Western countries, recurrences of sigmoid volvulus
after surgery are rare and due to a non resection of a dolicho-megacolon. Most
African studies do not report any recurrence of sigmoid volvulus after
sigmoidectomy. This work aims to describe three original cases of recurrence of
sigmoid volvulus after sigmoidectomy recorded at the University Hospital of
Brazzaville and to analyze their causes and surgical management. Clinical Observation: We studied the cases of three male patients, whose average age was 73
years, each of them having a history of chronic constipation and sigmoidectomy
for sigmoid volvulus with an average delay of recurrence of 5.3 years. They all
underwent emergency laparotomy for acute intestinal obstruction on scarred
abdomen. The surgery permitted to unfold a recurrent volvulus of the sigmoid
associated with circumferential scar fibrosis on the volvulated sigmoid loop. A
second colectomy was performed. The histological results of the surgical
specimens were normal for two patients and revealed signs of tissue necrosis
for the third patient. The postoperative outcome was without incident for two
patients. The third patient died after developing a septic shock. Conclusion: Recurrent sigmoid volvulus after sigmoidectomy is rare. The etiological factors
for our three patients were incomplete sigmoidectomy during the first operation
and chronic constipation.