Different clinicopathological features of non-elderly sigmoid volvulus patients
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ORIGINAL ARTICLE
Different clinicopathological features of non-elderly sigmoid volvulus patients Ufuk Uylas 1
&
Cuneyt Kayaalp 1
Accepted: 6 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Sigmoid volvulus is frequently seen in male patients over 60 years old. Here, we aimed to investigate the causes of sigmoid volvulus developing in patients under 60 years of age. Methods Patients diagnosed with sigmoid volvulus between 2009 and 2018 were retrospectively analyzed. The patients were divided into two as under 60 years old and above. The co-morbidity, mortality, morbidity, complications, age, and gender data were analyzed. Results A total of 134 patients were included. The median age was 70 (19–92), ≤ 59 age patients constituted 24% of all patients. Eighty-one percent (109/134) of the patients were male, and male/female ratio was lower in ≤ 59 age patients (2.0 vs 6.2, p = 0.01). Diseases that caused and underlying colon dilatation (mental retardation with hypomotility, pregnancy-puerperium, Hirschsprung’s disease, etc.) were more common in ≤ 59 age patients, but no observed at ≤ 60 age patients (15.2% vs 0%, p = 0.0007). While there was no difference between the two groups in terms of mortality, it was proportionally higher in the ≤ 60 age group (3.0% vs. 13.9%, p = 0.12). Conclusion By decreasing age, male dominance disappears progressively, and it is likely to have an underlying colonic hypomotility in young sigmoid volvulus patients. Keywords Dolichocolon . Volvulus . Sigmoid . Parkinson . Mental retardation . Hirschsprung’s disease
Introduction The incidence of sigmoid volvulus shows a wide geographic variation. Although it constitutes 20–54% of acute intestinal obstruction cases in areas with high incidence (endemic), its incidence in regions with low incidence (sporadic) is 2–5% [1, 2]. The average age of sigmoid volvulus in the endemic regions is 52 and the average age in sporadic ones is 68 [3]. Dolichocolon is essential for the development of sigmoid volvulus, but a certain process is required for the torsion. Elderly age, decreased physical activity, and constipation cause an enlargement in the sigmoid colon and a predisposition for the sigmoid volvulus. Underlying some chronical * Ufuk Uylas [email protected] Cuneyt Kayaalp [email protected] 1
Faculty of Medicine, Gastroenterology Surgery, Inonu University, Malatya, Turkey
diseases can cause bowel hypomotility and the formation of dolichocolon earlier in the non-elderly patients. Sigmoid volvulus is also common in cerebrovascular disease, Parkinson’s and Alzheimer’s disease, which is seen mostly in the elderly. Our aim was to investigate the causes of sigmoid volvulus in under 60 age group and present our own clinical results.
Materials and methods This retrospective study was conducted at Inonu University General Surgery Clinic in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by ou
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