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Sigmoid colon torsion: mortality and relevant risk factors.
- Source :
-
European review for medical and pharmacological sciences [Eur Rev Med Pharmacol Sci] 2013 Feb; Vol. 17 Suppl 1, pp. 127-32. - Publication Year :
- 2013
-
Abstract
- Introduction: Sigmoid volvulus is an important acute intestinal obstruction, leading to high mortality and requiring urgent operation. The purpose of this study is to analyze risk factors for mortality in patients that were operated on due to sigmoid volvulus at our Department.<br />Materials and Methods: The retrospective study included 158 patients, who were operated on due to sigmoid volvulus between January 1994-December 2010, in terms of age, gender, complaints at admission, physical signs, period of symptoms before admission, associated diseases, laboratory and radiological parameters, hospital stay, morbidity, and mortality.<br />Results: The study consisted of 135 men (85.4%) and 23 women (14.6%), with a mean age of 62.54 years. Cardiovascular disease and respiratory disease were present in 34 (21.5%) and 42 (26.6%) patients, respectively. Urgent operation was undertaken in 125, while 33 received elective surgery. Abdominal distension and pain was evident in all the patients. Generalized tenderness was detected in 58.2%, while 70.9% had hyperactive bowel sound with tympanism. Plain radiograph revealed an impression of "omega ans" in all patients, while free air was detected in 11.4% of them. Risk factors for mortality included age (p = 0.008), delayed admission (p = 0.001), cardiovascular and respiratory diseases (p = 0.001), fluid-electrolyte imbalance (p =0.001), presence of necrosis (p = 0.001), and major contamination (p = 0.001). Wound infection and intraabdominal abscess were more common in patients that developed mortality (p = 0.001 and p = 0.002).<br />Conclusions: Complications like wound infection and intraabdominal abscess are more frequent in the patients with the risk of mortality. Delayed admission results in higher risk of mortality. Mortality rates can be reduced by early admission, preoperative intensive resuscitation, suitable antibiotics, and emergent and viable surgery.
- Subjects :
- Abdominal Abscess mortality
Abdominal Pain etiology
Adolescent
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Digestive System Surgical Procedures adverse effects
Elective Surgical Procedures
Emergencies
Female
Humans
Intestinal Volvulus diagnosis
Intestinal Volvulus etiology
Length of Stay
Logistic Models
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Retrospective Studies
Risk Factors
Sigmoid Diseases diagnosis
Sigmoid Diseases etiology
Surgical Wound Infection mortality
Time Factors
Time-to-Treatment
Treatment Outcome
Young Adult
Digestive System Surgical Procedures mortality
Intestinal Volvulus mortality
Intestinal Volvulus surgery
Sigmoid Diseases mortality
Sigmoid Diseases surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1128-3602
- Volume :
- 17 Suppl 1
- Database :
- MEDLINE
- Journal :
- European review for medical and pharmacological sciences
- Publication Type :
- Academic Journal
- Accession number :
- 23436674