| 2009, Volume 41, Number 1, Page(s) 001-003 | |||
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| Serum Sodium Levels in Sigmoid Volvulus | |||
| S. Selcuk Atamanalp1, M. Sait Keles2, Gurkan Ozturk1, Bunyami Ozogul1, Abdullah Kısaoglu1, Ahmet Akbas1 | |||
| 1Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey 2Ataturk University, Faculty of Medicine, Department of Biochemistry, Erzurum, Turkey |
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| Keywords: Sigmoid colon, Volvulus, Sodium | |||
| Abstract | |||
Objective. Sigmoid volvulus (SV) is an uncommon type of
large bowel obstruction. This study sought to determine
serum sodium concentrations in patients with SV. Materials and Methods. The records of 89 patients with SV and 40 patients with obstructive rectosigmoid cancer (ORC) were reviewed retrospectively Results. The mean serum sodium concentrations in patients with SV and in those with ORC were 138.4±4.5 mEq/L and 137.7±3.2 mEq/L, respectively (t:0.7, P>0.05). The numbers of hyponatremic and hypernatremic patients were 13 vs. 4 and 1 vs. 0, respectively, in the SV and ORC groups (x2:0.5, P>0.05). Conclusion. No cause-effect relationship was determined between serum sodium concentrations and SV. |
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| Introduction | |||
Sigmoid volvulus (SV), the wrapping of the sigmoid
colon around itself and its own mesentery, is an uncommon
type of large bowel obstruction 1-4. Although
electrolyte imbalance is not marked in distal intestinal
obstructions, it is an important result of intestinal obstructions
5. In this article, serum concentrations of sodium, the
most important caution in organisms, were investigated in
patients with SV. |
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| Methods | |||
In this study, the clinical records of 89 patients with
sigmoid volvulus treated in the Department of General Surgery,
Faculty of Medicine, Ataturk University between July
1998 and June 2008 were reviewed retrospectively. The
records of 40 patients with obstructive rectosigmoid cancer
treated during the same period were considered as the control
group. Age, gender, and serum sodium concentrations that were obtained on admission were studied and compared. A level of 135-145 mEq/L was considered a normal serum sodium concentration. T and Chi-square tests were used in statistical analyses. The statistical significance level was set at P<0.05. |
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| Results | |||
The findings and the results of the statistical analyses
are given in Table 1. The mean age of the patients with sigmoid
volvulus (SV) was 61.7±16.7 years, while the mean age
of the patients with obstructive rectosigmoid cancer (ORC)
was 58.4±14.4 years. Of the patients with SV, 71 were male
and 18 were female, while the male/female ratio in the patients
with ORC was 21/19.
The mean serum sodium concentration was 138.4±4.5 mEq/L in the patients with SV and 137.7±3.2 mEq/L in the patients with ORC. Thirteen (14.6%) of the patients with SV were hyponatremic, while four patients (10.0%) were hyponatremic in ORC group. The numbers of hypernatremic patients were one (1.1%) and zero (0.0%) in the SV and ORC groups, respectively. There were no statistically significant differences between the two groups with respect to mean serum sodium concentrations or the numbers of hyponatremic and hypernatremic patients. |
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| Discussion | |||
Fluid-electrolyte imbalance is an inevitable result of
intestinal obstruction 5,6. During the early period of distal
intestinal obstruction, fluid loss into the lumen is evident, but
electrolyte imbalance is not apparent. In this period, minimal
decreases in serum sodium and potassium concentrations
are expected. Additionally, replacement of the intravascular
fluid loss with water with no sodium content may lead to
hyponatremia. As the obstruction is prolonged, retention of
sodium and discharge of potassium in and from the renal
tubules occur. Consequently, serum sodium levels may differ
relative to the severity and duration of the intestinal obstruction
5. Sigmoid volvulus (SV) is a type of distal colonic obstruction that leads to a closed-loop obstruction 1-4. Thus, SV may be expected to cause a fluid-electrolyte imbalance. In the present study, serum sodium concentrations were found to be normal in 84.3% of patients, but were lower in 14.6% and higher in 1.1% of the patients with SV. The differences between the rates of normonatremic, hyponatremic, and hypernatremic patients in the SV and obstructive rectosigmoid cancer groups were not statistically significant. Similarly, the mean serum sodium concentrations were statistically similar in the two groups. The results of the present study show that serum sodium concentration has no importance in SV. We can conclude that there is no cause-and-effect relationship between serum sodium concentrations and SV. Conflict interest statement The authors declare that they have no conflict of interest to the publication of this article. |
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| References | |||
1) Oren D, Atamanalp SS, Aydinli B et al. An algorithm
for the management of sigmoid colon
volvulus and the safety of primary resection:
Experience with 827 cases. Dis Colon Rectum
2007; 50: 489-97.
2) Atamanalp SS, Yildirgan MI, Basoglu M,
Kantarci M, Yilmaz I. Sigmoid colon volvulus
in children: review of 19 cases. Pediatr Surg
Int 2004; 20: 492-5.
3) Atamanalp SS, Oren D, Aydinli B et al. Elective
treatment of detorsioned sigmoid volvulus.
Turk J Med Sci 2008; 38: 227-34.
4) Atamanalp SS, Aydınlı B, Öztürk G et al. Classification
of sigmoid volvulus. Turk J Med Sci
2008; 38: 425-9.
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