Sigmoid Volvulus Complicating Pregnancy: A Case Report

Abstract

Sigmoid volvulus during pregnancy is a rare complication, and as of 2012, fewer than 100 cases had been reported. In this report, we present a 30 year-old pregnant woman with sigmoid volvulus, and we discuss this rare entity.

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 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.…”

“…It is extremely important to diagnose this condition early as a delay in diagnosis can lead to maternal as well as fetal complications. Maternal complications include bowel infarction and necrosis with hypovolemia, electrolyte disturbances, septic shock, multi-organ dysfunction and death [1,3,5,6]. Fetal complications include preterm delivery, intrauterine death and neonatal sepsis [5].…”

“…Fetal mortality in sigmoid volvulus is estimated to be approximately 30% [1,6]. The diagnosis of sigmoid volvulus in pregnancy is challenging as the symptoms and signs of intestinal obstruction could be masked by pregnancy itself [1,3,4,6,8]. Another problem faced by the clinicians is regarding the choice of the diagnostic imaging modality.…”

“…Magnetic resonance imaging scan could be used as a problem solving tool in the diagnosis of the cause of intestinal obstruction. It is not only free of radiation hazard but can also provide an accurate preoperative diagnosis of the etiology [3,4]. However, availability of MRI scan in many centers across developing countries is a limiting factor.…”