Skręt esicy z następową martwicą esicy – opis przypadku

*Anna Kosim, Małgorzata Kołodziejczak

Summary
Sigmoid volvulus occurs, when the intestine is twisted around the axis of it’s mesentery. It results in partial or total obstruction of the intestine, it can also lead to various levels of disturbance of blood flow in the organ.
This article presents a case of 76-year-old male, who experienced sigmoid volvulus. Patient was admitted to the hospital with symptoms of alimentary canal obstruction since about a week. Patient was in severe condition, in septic shock and was dehydrated. Abdominal x-ray showed dilated sigmoid, characteristic picture of ‘coffee bean’. Patient then was assessed for laparotomy. During the procedure, significantly enlarged sigmoid was already presenting with signs of necrosis. Hartman method sigmoid resection was performed. Patient was discharged 24 days after surgery in a satisfying condition, with the suture healed, with proper renal and haematological laboratory results.
Rapid surgical treatment, multidirectional postsurgical treatment and early rehabilitation can lead to better treatment results. In case of sigmoid volvulus with necrosis of the intestines Hartman method resection is the best treatment option. When the sigmoid volvulus is with no blood flow disturbances – then resection with primary colorectal anastomosis should be done.

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