This international service evaluation will examine how patients with sigmoid volvulus are currently managed and what outcomes they experience. The study aims to better understand recurrence, complications, hospital admissions, and survival to inform future guidelines and treatment decisions.
What issue does this study address?
Sigmoid volvulus occurs when the sigmoid colon (bowel) twists on its blood supply, resulting in a sudden blockage of the colon. Patients with sigmoid volvulus tend to be elderly and frail, and often have other significant health problems. It can also occur in patients who are on medications that slow the bowel down. This condition typically results in an emergency admission to hospital for treatment where patients will normally undergo a telescope test of the bowel (flexible sigmoidoscopy) to untwist the bowel and resolve the blockage. If the telescope test does prove successful, patients may improve but have a high risk of the bowel twisting again in the future.
Surgery is often the only way to permanently stop the twist happening again, but even as a planned operation, this carries a high risk of major complications, including dying from an operation. Due to this risk, some patients may present to hospital many times with sigmoid volvulus and undergo many sigmoidoscopies, all of which can severely reduce the patient’s quality of life, including increased dependence on others for daily care.
What are the aims and how could this work help?
With multiple options for management and limited research, it has been difficult to produce guidelines for the best management of sigmoid volvulus and determine who may benefit from what treatment option. This study aims to collect information about the current management of these patients with the aim of better understanding the patient who gets sigmoid volvulus and their patient journey, including rates of recurrence, hospital admissions and risk of death.
The research team
This research will be led by Mr Nick Heywood at East Lancashire Hospitals NHS Trust.