Treatment of sigmoid volvulus: experience in Gondar, north-west Ethiopia.

A retrospective study of 145 patients with sigmoid volvulus (SV) seen over a three year period is presented. Sigmoid volvulus (SV) was the commonest cause of emergency admissions with intestinal obstruction (56%). The mean age was 55 +/- 13 years, (range 10-80), and the male to female ratio was 13.5:1. The presence or absence of a previous attack makes a significant difference in the occurrence of gangrenous bowel. Eighteen out of 75 patients (24%) with no previous attack had gangrenous bowel compared with 2 out of 57 (4%) after recurrence. A conservative sigmoidoscopic detorsion was successful in the majority of the cases (63%). Elective surgery after bowel preparation was associated with a mortality rate of 3% in comparison to 12.5 mortality rate in patients with viable bowel operated on an emergency basis (p < 0.05). Sigmoidoscopic detorsion should be the first measure in patients with viable bowel.