Sigmoid volvulus in pregnancy: case report and review of literature

Abstract

Key Clinical MessageSigmoid volvulus in pregnancy is a very rare condition. Despite this, clinicians should have a high index of suspicion of this condition if they encounter a pregnant woman with symptoms suggestive of bowel obstruction. Incorrect diagnosis may be catastrophic, resulting in major complications, including fetal and maternal death.

Sigmoid Volvulus in Pregnancy Mimicking Abruptio Placenta

“…A high index of suspicion of sigmoid volvulus is required when a pregnant lady presents with a clinical triad of abdominal pain, distention, and absolute constipation [3,4]. However in this patient, there was no suspicion of volvulus since she was still able to pass flatus and stool, with vomiting being the only symptom of intestinal obstruction.…”

“…Houston, first described intestinal obstruction in pregnancy in 1830, which was a rare entity [1]. Sigmoid volvulus is the most common cause of bowel obstruction complicating pregnancies up to 44 percent of cases [2,3]. There were only 101 cases of sigmoid volvulus in pregnancy and puerperium reported in literature to the year 2016 [1,3,4].…”

“…Sigmoid volvulus is the most common cause of bowel obstruction complicating pregnancies up to 44 percent of cases [2,3]. There were only 101 cases of sigmoid volvulus in pregnancy and puerperium reported in literature to the year 2016 [1,3,4]. It is postulated that the occurrence of sigmoid volvulus in a gravid uterus is due to displacement of redundant or an abnormally elongated sigmoid colon out of pelvis hence increasing risk of rotation at the mesenteric axis which is common during the 3 rd trimester [1,4].…”

Sigmoid volvulus in pregnancy: a case report

“…Classic presentation of sigmoid volvulus is abdominal distension, constipation, and abdominal pain, which were present in the index case; however, obstructive symptoms can be unspecific in pregnancy as they can be related to the pregnancy. Nevertheless, common features of IO in pregnancy include abdominal pain (98%), vomiting (82%), and constipation (30%) [ 1 , 2 , 4 ]. Vomiting was a strong feature in our case as the NGT was draining fecal contents to support the diagnosis of IO.…”

“…Fetal mortality is said to be 30% [ 2 ]. Other maternal complications include perforation, peritonitis, and sepsis, and fetal complications include preterm delivery, intrauterine fetal death, and neonatal sepsis [ 4 ].…”