Hartmann colostomy in the management of sigmoid volvus: a case report

Abstract

Sigmoid colonic volvulus is an incidental cause of large bowel obstruction. This pathology manifests clinically with abdominal pain, distension and constipation and in some cases, in addition to these findings, vomiting, nausea and anorexia may occur. This report describes the case of a patient (75 years old) with complaints of abdominal pain on superficial and deep palpation associated with fecal vomiting and constipation that evolved with the need for surgical approach due to torsion and non-viability of the sigmoid colon loop. The diagnosis was confirmed by physical examination, laboratory and imaging tests. The treatment of choice was sigmoidectomy with mesocolon ligation and colostomy of the descending colon using the Hartmann technique, obtaining clinically satisfactory results with good response and significant improvement of the obstructive condition. As this is a disease with a high morbidity and mortality rate, this report aims to demonstrate the importance of early diagnosis and adequate clinical treatment to reduce therapeutic failure, complications and recurrences of the disease, which can significantly affect the postoperative period and quality of life of patients with this obstructive condition.