JOCS
Journal of Comprehensive Surgery

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-0862
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Can inflammatory markers predict intestinal wall ischemia in sigmoid volvulus?
Abstract
Aims: Sigmoid volvulus (SV), which causes closed-loop obstruction as a result of the rotation of the sigmoid colon around its mesentery, causes serious morbidity and mortality, especially in elderly patients, when necrosis develops in the intestine. In this study, it was investigated whether inflammatory markers, which guide the diagnosis and prognosis of many intra-abdominal pathologies, can predict the presence of ischemia in the intestine in patients with SV.
Methods: In the study, patients who were operated on for SV in our clinic between January 2019 and March 2022 were retrospectively screened, and the demographic, clinicopathological, and laboratory parameters of the patients were examined. Data were analyzed with the Student’s T test and Mann-Whitney U-test.
Results: Of the 47 patients included in the study, 28 (59.6%) were male and 19 (40.4%) were female. Intestinal necrosis was detected in 23 (48.9%) patients who underwent surgery. The mean age of the patient population was 70 (±19). There was no statistical difference between the two groups according to age (p=0.338). White blood cell count (WBC) (p=0.686); Neutrophil count (p=0.949); Lymphocyte count (p=0.790); Monocyte count (p=0.898); Neutrophil-lymphocyte ratio (NLR) (p=0.733); Platelet count (p=0.766); RDW value (p=0.725); There was no statistically significant difference between the two groups in lactate level (p=0.289), C-reactive protein (CRP) (p=0.212), Amylase (p=0.975) and Lactate dehydrogenase (LDH) (p=0.974) levels.
Conclusion: Detection of intestinal necrosis is a vital condition for the patient. Inflammatory biomarkers obtained from preoperative routine blood parameters were not found to be significant in estimating the presence of intestinal necrosis in the SV clinic. It was concluded that large series are needed in this regard.

Keywords : Sigmoid, volvulus, ischemia

Download Article


1. Alavi K, Poylin V, Davids JS, et al. The American Society ofColon and Rectal Surgeons Clinical Practice Guidelines forthe management of colonic volvulus and acute colonic pseudo-obstruction. Dis Colon Rectum. 2021;64(9):1046-1057. doi:10.1097/DCR.0000000000002159
2. Raveenthiran V, Madiba TE, Atamanalp SS, De U. Volvulus of thesigmoid colon. Colorectal Dis. 2010;12(7 Online):e1-e17. doi:10.1111/j.1463-1318.2010.02262.x
3. Ballantyne GH, Brandner MD, Beart RW Jr, Ilstrup DM. Volvulusof the colon. Incidence and mortality. Ann Surg. 1985;202(1):83-92.doi:10.1097/00000658-198507000-00014
4. Quénéhervé L, Dagouat C, Le Rhun M, et al. Outcomes of first-lineendoscopic management for patients with sigmoid volvulus. DigLiver Dis. 2019;51(3):386-390. doi:10.1016/j.dld.2018.10.003
5. Atamanalp SS, Atamanalp RS. What is done when endoscopicexamination reveals borderline bowel ischemia in patients withsigmoid volvulus?. Pak J Med Sci. 2017;33(3):761-763. doi:10.12669/pjms.333.12265
6. Atamanalp SS. Treatment of sigmoid volvulus: a single-centerexperience of 952 patients over 46.5 years. Tech Coloproctol.2013;17(5):561-569. doi:10.1007/s10151-013-1019-6
7. Atamanalp SS, Atamanalp RS. The role of sigmoidoscopy inthediagnosis and treatment of sigmoid volvulus. Pak J Med Sci.2016;32(1):244-248. doi:10.12669/pjms.321.8410
8. Gibney EJ. Volvulus of the sigmoid colon. Surg Gynecol Obstet.1991;173(3):243-255.
9. Yasuda K, Oura S, Kashu N, et al. Sigmoid volvulus with widespreadbowel ischemia after endoscopic reduction successfully treatedwith elective laparoscopic surgery. Case Rep Gastroenterol.2020;14(2):286-290. doi:10.1159/000507611
10. Oren D, Atamanalp SS, Aydinli B, et al. An algorithm forthe management of sigmoid colon volvulus and the safety ofprimary resection: experience with 827 cases. Dis Colon Rectum.2007;50(4):489-497. doi:10.1007/s10350-006-0821-x
11. Uylas U, Kutluturk K, Sumer F, Kayaalp C. Endoscopic sign insigmoid volvulus with mucosal ischemia:“autumn leaves”. Indian JSurg. 2021;83(1):373-374. doi: 10.1007/s12262-020-02341-5
12. Bhatnagar BN, Sharma CL, Gautam A, Kakar A, Reddy DC.Gangrenous sigmoid volvulus: a clinical study of 76 patients. Int JColorectal Dis. 2004;19(2):134-142. doi:10.1007/s00384-003-0534-8
13. Ballantyne GH. Review of sigmoid volvulus: history and resultsof treatment. Dis Colon Rectum. 1982;25(5):494-501. doi:10.1007/BF02553666
14. Khan SM, Emile SH, Wang Z, Agha MA. Diagnostic accuracyof hematological parameters in Acute mesenteric ischemia-Asystematic review. Int J Surg. 2019;66:18-27. doi:10.1016/j.ijsu.2019.04.005
15. Bostancı MT, Yılmaz I, Seki A, Saydam M, Kosmaz K, Kaya IO.Haematological inflammatory markers for indicating ischemicbowel in patients with incarcerated bdominal wall hernias. Hernia.2022;26(1):349-353. doi:10.1007/s10029-021-02518-1
16. Ceylan C, Baran NT, Kocaaslan H, et al. A new model for predictionof bowel gangrene in sigmoid volvulus. Sigmoid volvulus’ta bağırsakgangreninin tahmininde yeni bir model. Ulus Travma Acil CerrahiDerg. 2023;29(4):471-476. doi:10.14744/tjtes.2022.11893
17. Thompson JS, Bragg LE, West WW. Serum enzyme levelsduring intestinal ischemia. Ann Surg. 1990;211(3):369-373.doi:10.1097/00000658-199003000-00009
18. Acosta S, Björck M. Acute thrombo-embolic occlusion of thesuperior mesenteric artery: a prospective study in a well definedpopulation. Eur J Vasc Endovasc Surg. 2003;26(2):179-183. doi:10.1053/ejvs.2002.1893
Article available in :
Volume 1, Issue 3, 2023
Page : 53-56
https://doi.org/10.51271/JOCS-0013
Article Information
Received : 25 Tem 2023
Accepted : 29 Ağu 2023
Published : 31 Ağu 2023
Corresponding Author :

Sadettin Er: Department of General Surgery, Ankara Bilkent City Hospital, Ankara, Turkey

[email protected]
Citation : Ertenlice A, Göktaş A, Pak MA, et al. Can inflammatory markers predict intestinal wall ischemia in sigmoid volvulus?. J Compr Surg. 2023;1(3):53-56.

Read: 480
Cited: 0
Download : 278
_Footer