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      Sigmoid volvulus in pregnancy and puerperium: a case series

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          Abstract

          Intestinal obstruction due to sigmoid volvulus during pregnancy is rare. The presenting signs/symptoms seen in these patients are the same as with non-pregnant patients. Fetal and maternal mortality rates are higher during pregnancy due to delays in diagnosis. We aimed to present four patients diagnosed with sigmoid volvulus during pregnancy and puerperium in our clinic. Diagnosis requires a high index of suspicion in a patient who presents with complaints of abdominal pain and evidence of bowel obstruction. Prompt intervention is necessary to minimize maternal and fetal morbidity and mortality.

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          Volvulus of the colon. Incidence and mortality.

          GARTH BALLANTYNE, MICHAEL BRANDNER, ROBERT BEART … (1985)
          Between 1960 and 1980, 137 patients with colonic volvulus (52% cecal, 3% transverse colon, 2% splenic flexure, and 43% sigmoid) were seen at the Mayo Clinic. Among the 59 patients with sigmoid volvulus, four (7%) had colonic infarction. Total mortality with sigmoid volvulus was seven per cent. There were 71 patients with cecal volvulus. Colonoscopic decompression was accomplished in two of these patients; in 15 (21%), gangrenous colon developed and mortality was 33%. Total mortality for cecal volvulus patients was 17%. Mortality for all forms of volvulus in patients with viable colons was 11%. Mortality for all patients with volvulus was 14%.
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            Small bowel obstruction in pregnancy.

            S Rickes, Stefanie Wolff, Carrie A. Redlich … (2007)
            Intestinal obstruction in pregnancy is rare. Symptoms are often unspecific and a high level of suspicion is essential for early diagnosis. Fetal and maternal mortality rates are higher during pregnancy due to delay in diagnosis. A 31-year-old primigravida with a history of abdominal surgery was admitted because of worsening abdominal pain, abdominal distension and elevated pancreatic enzymes. Ultrasound showed dilated small bowel loops. Explorative laparotomy revealed a small bowel obstruction with partial bowel necrosis caused by a single adhesion. A jejuno-jejunostomy was performed. Five days later, she developed peritonitis. A secondary laparotomy and caesarean section were done. In spite of timely diagnosis and prompt surgical intervention, our case was still complicated by peritonitis and early delivery. This underlines the necessity of immediate clinical suspicion. Small bowel obstruction should be considered in differential diagnosis of pregnant patients with a history of abdominal surgery.
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              Volvulus complicating pregnancy and puerperium; report of three cases and review of literature.

              W Benson Harer (1958)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cases J
                Title: Cases Journal
                Publisher: BioMed Central
                ISSN (Electronic): 1757-1626
                Publication date Collection: 2009
                Publication date (Electronic): 17 September 2009
                Volume: 2
                Page: 9275
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, Yuzuncu Yil University School of Medicine, Van, Turkey
                [2 ]Department of General Surgery, Yuzuncu Yil University School of Medicine, Van, Turkey
                Article
                Publisher ID: 1757-1626-0002-0000009275
                DOI: 10.4076/1757-1626-2-9275
                PMC ID: 2827085
                PubMed ID: 20184713
                SO-VID: 6888b51e-8c1f-41f4-9e68-e6247f006d0d
                Copyright © Copyright ©2009 Kolusari et al.; licensee Cases Network Ltd. licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 20 December 2008
                Date accepted : 28 August 2009
                Categories
                Subject: Research article

                ScienceOpen disciplines: Medicine
                Data availability:
                ScienceOpen disciplines: Medicine

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