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sigmoid volvulus, Intestinal Obstruction and Bowel Perforation;an Unusual Presentation of Pedunculated Fibroid Torsion. Case Report

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Case Reports in Clinical Medicine 2021年第10期10卷 308-313页

作者： Emmanuel Mamah Azubuike Onyebuchi Chichetaram Otu Nnaemeka Egbuonu Parakrama Happawana Department of Obstetrics and Gynaecology Homerton University Hospital NHS Foundation Trust London UK Federal Medical Centre Umuahia Nigeria Government House Clinic Abakaliki Nigeria Queens Hospital Romford Essex

Pedunculated fibroid torsion presenting as a case of acute abdomen from sigmoid volvulus and large bowel perforation is rare. Without prompt diagnosis and intervention, this could lead to serious morbidity and mortality. Ms FM was a 52-year-old perimenopusal woman who was admitted to the Intensive Therapy Unit (ITU) with worsening symptoms of confirmed Covid-19 infection. On the 10th day of her admission, she developed abdominal distension and tenderness. A pelvic ultrasound scan showed a large pedunculated fibroid measuring 23 × 15 × 22 cm. The plan was for conservative management to use pain killers. Following deterioration of her clinical state, an abdominal CT scan was done which confirmed a large uterine fibroid, large bowel distention. CT findings also showed sigmoid volvulus and large bowel perforation. Following a multidisciplinary team assessment, she had an emergency exploratory laparotomy with findings of a large, torted, pedunculated fibroid with adherent sigmoid colon which had become twisted and obstructed. The large bowel segment above the sigmoid volvulus was grossly distended and there was a gangrenous hepatic flexure with perforation. She had a right hemicolectomy, a de-functioning colostomy and subtotal hysterectomy. Postoperatively, she made very good clinical improvement. Fibroid histology report showed tissue infarction and necrosis which confirmed the torsion. She was discharged home after making good recovery.

关键词： Case Report Bowel Perforation Fibroid Torsion Pedunculated Fibroid sigmoid volvulus

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volvulus of sigmoid Colon at Sikasso Hospital

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Surgical Science 2020年第2期11卷 15-24页

作者： A.Maiga T.Bathio M.Diassana I.Diakité M.B.Y.Sidibé T.Koné Z.Saye A.Bah A.B.Diallo A.A.Traoré M.Diallo B.T.Dembélé O.H.Saadé M.Kanté M.Konaté S.Dembélé M.Samaké A.Togo A.Traoré Service of General Surgery Teaching HospitalBamakoMali Service of General Surgery Hospital of SikassoSikassoMali Reference Heath Center of Commune VI BamakoMali

The sigmoid volvulus is an acute strangulation of the colon by the twisting of the sigmoid loop around its mesenteric axis resulting in partial or complete obstruction of the colonic lumen. It is the most common intestinal volvulus and is an absolute medical and surgical emergency. Objectives: Determine the frequency of sigmoid colon volvulus, describe clinical and para-clinical signs, describe treatment, and determine morbidity and mortality. Methodology: This was a retrospective and prospective study performed in the General Surgery Department of Sikasso. This study concerned patients admitted and operated for sigmoid volvulus from January 1, 2014 to December 31, 2017. Retrospective Phase: We have created survey cards to study the following parameters: 1) The age and the sex;2) The clinical signs and associated defects;3) The radiological examinations, endoscopic;4) The established treatment whether medical, or surgical;5) The evolution and the postoperative consequences;6) The admission period. Prospective Phase: At the admission each patient to benefit: a complete interrogation, a complete physical examination, additional examinations including radio of the abdomen without preparation, the rate of hemoglobin and hematocrit, grouping/rhesus. Support: Our data were collected from medical records and operating records of patients in the department. Results: We collected 54 cases of sigmoid volvulus (the annual frequency was 13.5 cases for year), which accounted for 58.1% of colonic occlusions 19.6% of intestinal occlusions and 5.9% of operative operations in emergency. The average age was 47.13 with extremes of 18 and 102 years, The sex ratio is 4.40% in favor of men. Abdominal pain, vomiting, stopping of materials and gases were present in 32 (59.3%) patients. Von Wahl’s triad was present in 36 patients (66.7%), the rectal ampoule empty in 92.6%. On the X-ray of the abdomen without preparation, 70.37% of the image was recorded as a double leg. The sigmoid was necrotic in 37% of cases, and a sigmoid volvulus and

关键词： sigmoid volvulus Surgical Emergency Sikasso Hospital

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volvulus of Colon sigmoide in the General Surgery Department of Chu Gabriel Toure

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Surgical Science 2022年第1期13卷 46-52页

作者： Maïga Amadou Diakité Ibrahima Bah Amadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Sidibé Boubacar Yoro Koné Tani Doumbia Arouna Adama Traoré Amadou Saye Zakari Diallo Mamadou Konaté Moussa Saadé Oumou Hélène Kanté Lassana Konaté Madiassa Dembélé Souleymane Samaké Moussa Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné General Surgery Department University Hospital Bamako Mali General Surgery Department Sikasso Hospital Sikasso Mali Reference Center of Commune VI Bamako Mali

Introduction: sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing l... 详细信息

Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1]. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2]. Objective: To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus.

关键词： sigmoid volvulus General Surgery Department

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sigmoide volvulus on Pregnancy in the General Surgery Service of the Sikasso Hospital,Mali

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Surgical Science 2019年第7期10卷 229-234页

作者： A.Maiga T.Bathio M.Diassana I.Diakité A.Bah A.B.Diallo A.A.Traoré M.Diallo B.T.Dembélé B.Y.Sidibé O.H.Saadé M.Kanté M.Konaté S.Dembélé M.Samaké A.Togo A.Traoré G.Diallo Service of General Surgery Teaching HospitalBamakoMali Service of General Surgery Hospital of SikassoSikassoMali Reference Heath Center of Commune VI BamakoMali

sigmoid volvulus on pregnancy is a rare surgical emergency. We report two cases treated in the General Surgery Department of Sikasso Hospital between January 2009 and December 2017. The mean age was 34.8 years and the gestational age ranged from 28 to 30 weeks. The evolution time was 4 days. The 2 patients were referred to us by gynecologist-obstetricians. They were operated after a short-term resuscitation. Inoperative the volvulus of the sigmoid was alone in 1 case;he was associated with a hail volvulus in the other. The volvated loop was necrotic in 1 case (small and sigmoid). A patient benefited from the Hartmann operation associated with a small bowel resection with end-to-end anastomosis. Simple sigmoidal detorsion was performed in one patient. We did not register a maternal death. The follow-up was simple in the 2 patients who gave birth vaginally.

关键词： sigmoid volvulus Surgical Emergency Pregnancy

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