A Case of Sigmoid Volvulus in Pregnancy: A Rare Emergency in Pregnancy

Authors

1 Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Shahid Faghihi Hospital, Department of Gynecology and Obstetrics, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Assistant Professor, Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Emergency Medicine Department, Faculty of Medicine, Sabzevar University of Medical Science, Sabzevar, Iran.

5 Students Research Committee, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.

6 Kowsar Hospital, Department of Gynecology and Obstetrics, Shiraz University of Medical Sciences, Shiraz, Iran.

7 Assistant Professor, Department of Obstetrics and Gynecology, Neonatal and Maternal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background
Sigmoid volvulus (SV) in pregnancy is a very rare entity, which can be associated with extremely high rates of mortality and morbidity for both mother and fetus.
Care Report
A 22-year-old female patient with a first pregnancy with a gestational age of 27 weeks was referred to the Omolbanin hospital, Mashhad, Iran, and presented with generalized pain, abdominal swelling, and abnormal bowel movements from a week ago. Intestinal loops with thick wall and fluid content decreased with decrease in peristalsis was seen in abdominal and pelvic ultrasound. In addition, abdominal and pelvic X-ray examination showed enlarged bowel with bent inner tube view. Due to severe abdominal pain and available evidence, she underwent laparotomy for suspected intestinal obstruction. A dilated sigmoid colon rotated about two times around its mesentery   was seen adjacent to the pregnant uterus. The sigmoid was detorted and was fixed to the pelvic floor through its mesentery. The patient was discharged 4 days after surgery in good general condition, and her baby was born at 38 weeks of gestation by natural vaginal delivery.
Conclusion
Sigmoid volvulus during pregnancy is a rare complication. Its timely diagnosis will prevent intestinal gangrene and reduce maternal and fetal damage.

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