Endoscopic reduction of a volvulus of the sigmoid colon in pregnancy: case report and a comprehensive review of the literature

Abstract

Sigmoid volvulus is a rare, but serious, complication that can occur during pregnancy. We present a case of a 33-year-old pregnant female in the third trimester with a sigmoid volvulus. Detorsion of the volvulus was performed during colonoscopy. The patient underwent an elective sigmoidectomy at a later date. Prompt diagnosis of the volvulus sigmoid is critical to minimize fetal and maternal morbidity and mortality. Sigmoidoscopic detorsion or surgical resection are the treatment options, depending on bowel viability. A review of the literature was done.

Sigmoid volvulus in pregnancy: case report and review of literature

“…In cases with dead intestine, resection and formation of a stoma are the necessary actions which must be taken. Even though many surgeons attempt primary anastomosis in cases with uncomplicated sigmoid volvulus, this requires further thought in pregnant patients as an anastomotic leak can result in major problems to the gravid uterus and fetus 2, 3, 8. In this case, the intestinal wall showed no signs of vascular compromise, so after unwinding and decompression, the sigmoid colon was put back in place.…”

“…In the absence of peritoneal signs or mucosal ischemia, it would seem reasonable to attempt detorsion and decompression via sigmoidoscopic placement of a soft rectal tube, volvulus distortion through a flexible sigmoidoscopy, or colonoscopy 2, 3, 7.…”

Sigmoid volvulus during second trimester of pregnancy in a primigravida: Report of a rare case with review of imaging of sigmoid volvulus

“…The incidence of intestinal obstruction in pregnancy ranges from 1:1500 to 1:66431 [1][2][3][4]. The differential diagnosis for intestinal obstruction in pregnancy includes congenital or postoperative adhesions, volvulus, hernia, intussusception, malignancy and appendicitis [1,2,4,5].…”

“…The incidence of intestinal obstruction in pregnancy ranges from 1:1500 to 1:66431 [1][2][3][4]. The differential diagnosis for intestinal obstruction in pregnancy includes congenital or postoperative adhesions, volvulus, hernia, intussusception, malignancy and appendicitis [1,2,4,5]. Sigmoid volvulus is the most common cause of intestinal obstruction accounting for 25-44% of the reported cases in literature [1][2][3][4][5][6][7].…”

“…The differential diagnosis for intestinal obstruction in pregnancy includes congenital or postoperative adhesions, volvulus, hernia, intussusception, malignancy and appendicitis [1,2,4,5]. Sigmoid volvulus is the most common cause of intestinal obstruction accounting for 25-44% of the reported cases in literature [1][2][3][4][5][6][7]. It is extremely important to diagnose this condition early as a delay in diagnosis can lead to maternal as well as fetal complications.…”