A modification of the paul-mikulicz procedure in the surgical treatment of sigmoid colon volvulus

Abstract AR

Objective: A modification of the classical Paul-Mikulicz procedure has been used in the emergency surgical treatment of sigmoid volvulus in a number of cases at Al Kindy Hospital in Baghdad, Iraq.

These cases are presented in order to demonstrate the advantages of this modification among other surgical approaches for volvulus.

Methods: This prospective study was conducted at Al Kindy Teaching Hospital in Baghdad, Iraq between December 2000 and January 2004.

The modification consists of fashioning the colostomy by suturing the adjacent micosa of the two limbs together without placing sutures in between the deepest, approximated, antimesenteric )orders.

Final closure of this colostomy was similar to that of loop colostomy closure.

All the colostomies were iosed intra-pentoneally.

Results : This modification was used in eleven patients with sigmoid volvulus who required emergency surgical nterference, five females (45A5%) and six males (54.54%) with a median age 58 years (range 48-65).

Only one mtient (9.09%) developed wound infection and another patient (9,09%) developed a mild degree of colostomy etraction.

All patients underwent colostomy closure six weeks later with uneventful recovery.

Conclusion: This modification has been used successfully in the emergency surgical treatment of sigmoid 'olvulus in this series.