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.
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.
Sigmoid volvulus during pregnancy is a rare complication. Its timely diagnosis will prevent intestinal gangrene and reduce maternal and fetal damage.