Patterns of small bowel volvulus in North - Eastern Ethiopia

BACKGROUND: Small bowel volvulus (SBV) is a condition where the small bowel loops coil around the axis of their own mesentery, which can lead to mechanical intestinal obstruction. It contributes a significant number of patients at surgical emergency with small bowel obstruction (SBO), especially in developing countries. The main objective of this study was to assess the clinical and epidemiological status of SBV in North-Eastern Ethiopia. METHOD: The study was conducted at Dessie Comprehensive and Specialized Hospital, Dessie, Ethiopia. The study period was in November 2023. A hospital-based retrospective cross-sectional study design was used, and data were collected with a standardized structured checklist. Data were collected from medical records of adult patients with a discharge diagnosis of small bowel obstruction over a four (4)-year period from September 1, 2019, to August 31, 2023. Cross-tabulation analysis was done for factors that contributed to the mortality and morbidity of SBV. RESULT: A total of 162 patients with small bowel volvulus were included in the study, accounting for about 37.2% of patients with small bowel obstruction, with an average annual occurrence rate of about 40.5 patients. The mean age of patients was 47 years. The majority of them (93.8%) were males. The common seasons at presentation were September-November and March-May. All participants had abdominal pain and vomiting, but 98.1% and 88.3% had abdominal distension and constipation, respectively. 52.5% of patients with SBV presented within 24 h of symptom onset, and 61.1% had normal complete blood count results, whereas 38.9% had leukocytosis. The majority (77.1%) were managed with derotation and retrograde milking, whereas 7.4% were managed with resection and anastomosis, and 11.1% underwent band release and derotation. Primary small bowel volvulus was seen in 85.2% of patients, and the remaining 14.8% had secondary small bowel volvulus. CONCLUSION: The prevalence of SBV among patients with SBO was 37.2%, with 85.2% being primary and the remaining 14.8% being secondary types. The average annual occurrence rate was about 40.5 patients per year, with a mean age of 47 years.