European Journal of Cardiovascular Medicine

Introduction: Sigmoid volvulus is an obstructive bowel disease caused by abnormal twisting of sigmoid colon about its mesentery. It commonly affects the middle aged and elderly adults. It is the third most common cause of acute large-bowel obstruction, it accounts for 75% of all patients with volvulus. Many different parameters have been used for the classification of SV. These include clinical timing, classified as acute (fulminant), subacute (indolent) or chronic (recurrent); severity (complete or incomplete), prevalence (sporadic or endemic) and axis of rotation (mesenterio -axial and organ axial organ axial types). Materials And Methods: This is a prospective study was conducted among patients suspected to have sigmoid volvulus by clinical feature and abdominal X-ray. A total of 144 patients were selected from Emergency department, VSSIMSAR, Burla over the 2 years study period. After evaluation and assessment, patients were categorized into 3 groups according to the angle between the mesenteric axis of sigmoid colon and the horizontal line on abdominal X-ray anteroposterior view (coffee bean sign) a per axis classification. All the studied cases underwent emergency exploratory laparotomy. Resection of the volvulus segment was done. Result: In our study, Patients of study had 2.49 gm/dL mean value of Serum albumin. 107 (74.3%) out of 144 patients were in shock at the time of presentation. In Group A, Group B and Group C 58.7%, 90.9% and 92.8% patients were in shock at the time of presentation respectively.  49 (34%) out of 144patients had Gangrenous sigmoid colon at laparotomy. Gangrene in colon was evident in 92.9%, 49.1% and 12 % in Group c, Group B and Group C respectively. The difference between 3 Groups were statistically significant, P value was less than 0.001. Conclusion: With increased axis, the AXIS C having poor prognostic factors leading to increased 30 days mortality rate. Therefore, increased axis is associated with increased 30 days mortality rate of patients. Preoperative serum albumin level also decreased with the progression of the AXIS leading to increased postoperatively complications like wound dehiscence, SSI, chest complications, anastomosis leak etc. The AXIS classification system enables the prediction of the severity of sigmoid volvulus and facilitates treatment decision-making at an early stage of the disease. With the AXIS classification system, a simple abdominal X-ray performed in the emergency room used to predict the severity of sigmoid volvulus