Abstract
Sigmoid volvulus (SV) is uncommon in the United States. Little has been published in the English literature about the high incidence of SV among rural areas of the Bolivian and Peruvian Andes at 13,000 feet above sea level. A review of 230 cases of SV in a Bolivian hospital is presented. SV accounted for 79 percent of all intestinal obstructions. Nonoperative reduction was attempted in all patients except those with peritonitis. Nonoperative reduction alone was performed in 31 percent of the patients, and 69 percent underwent surgical intervention, 66 percent as an emergency and 3 percent electively. Surgical treatment consisted of sigmoidectomy and primary anastomosis (50 percent), Hartmann's procedure (12 percent), and operative detorsion with sigmoid plication (38 percent). Overall mortality was 13.5 percent. Fifty-seven of the surgically treated patients developed significant complications. The etiology of SV is unclear. High altitude, along with other etiologic factors, may play an important role in SV. To our knowledge, this series represents the highest incidence of SV in bowel obstruction.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Friedman JD, Odland MD, Bubrick MP. Experience with colonic volvulus. Dis Colon Rectum 1989;32:409–16.
Ballantyne GH. Review of sigmoid volvulus: clinical patterns and pathogenesis. Dis Colon Rectum 1982;25:823–30.
Frisancho D. Dolicomegasigmoides volvulado. Presented at Vill Latin American Colorectal Meeting Montevideo, January 1981.
Wenger F. situacion del colon ileo-pelvico y su relacion con el volvulo. Gac Med Quir Bolivia 1943;1(2):84.
Marino F, y Frisancho D. Rev Med Puno 1954;1:10.
Frisancho D. El colon y sus particularidades en el hombre del Altiplano. Acad Per Cir 1959;12:240.
Brydon WG, McKay LF, Eastwood MA. Intestinal gas formation and the use of breath measurements to monitor the influence of diet and disease. Dig Dis 1986;4:1–12.
Saidi F. The high incidence of intestinal volvulus in Iran. Gut 1969;10:838–41.
Sinha RS. A clinical appraisal of volvulus of the pelvic colon: with reference to aetiology and treatment. Br J Surg 1969;56:838–40.
Bruusgaard C. Volvulus of the sigmoid colon and its treatment. Surgery 1947;:22:466–78.
Jain BL, Seth KK. Volvulus of intestine: a clinical study. Indian J Surg 1968;30:239–46.
Agrawal RL, Misra MK. Volvulus of the sigmoid colon. Int Surg 1971;55:49–56.
Essenson L, Ginzburg L. Volvulus of the sigmoid. Am J Surg 1949;77:240–9.
Shepherd JJ. The epidemiology and clinical presentation of sigmoid volvulus. Br J Surg 1969;56:353–9.
Habr Gama A, Haddad J, Simonsen O,et al. Volvulus of the sigmoid colon in Brazil: a report of 230 cases. Dis Colon Rectum 1976;19:314–20.
Methany D, Nichols HE. Volvulus of the sigmoid. Surg Gynecol Obstet 1943;76:239–46.
Lasaro EJ, Das PB, Abraham PV. Volvulus of the sigmoid colon complicating pregnancy. Obstet Gynecol 1969;33:553–7.
Morris ED. Intestinal obstruction and pregnancy. J Obstet Gynaecol Br Commonw 1965;72:36–44.
Brooks VE, Butler A. Acute intestinal obstruction in Jamaica. Surg Gynecol Obstet 1966;122:261–3.
Frisancho D. El dolico-mega-colon, como caracteristica del hombre del altiplano. Presented at the XIII Peruvian Surgical Meeting, Lima, Peru, 1961.
Ballantyne GH. Review of sigmoid volvulus: history and results of treatment. Dis Colon Rectum 1982;25:494–501.
Pahlman L, Enblad P, Rudberg C, Krog M. Volvulus of the colon: a review of 93 cases and current aspects of treatment. Acta Chir Scand 1989;155:53–6.
Peoples JB, McCafferty JC, Scher KS. Operative therapy for sigmoid volvulus: identification of risk factors affecting outcome. Dis Colon Rectum 1990;33:643–6.
Author information
Authors and Affiliations
About this article
Cite this article
Asbun, H.J., Castellanos, H., Balderrama, B. et al. Sigmoid volvulus in the high altitude of the Andes. Dis Colon Rectum 35, 350–353 (1992). https://doi.org/10.1007/BF02048112
Issue Date:
DOI: https://doi.org/10.1007/BF02048112