Sigmoid volvulus during pregnancy: A rare non-obstetric complication. Report of a case and review of the literature
| Autor: | Mohamed M. Moneer, Adel K. Barsoum, Ahmed M. Al Maksoud |
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| Rok vydání: | 2015 |
| Předmět: | |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Sigmoid volvulus is a rare complication during pregnancy with potentially fatal feto-maternal complications. • Early diagnosis of SV in pregnancy is still a great challenge and represents the most important factor in reducing the high rates of mortality. • A multidisciplinary approach is required for favourable management. • Endoscopic detorsion or surgical resection are the treatment options, depending on bowel viability. • High incidence of suspicion and timely surgical intervention are key to a favourable outcome. Introduction Sigmoid volvulus is a rare cause of intestinal obstruction during pregnancy associated with high maternal and foetal mortality. Effective management represents a challenge due to delayed presentation, obstructive symptoms regarded as pregnancy-related and hesitation in using radiological evaluation. Presentation of case We report a case of a lady, pregnant for 26 weeks and with a 5 day history of abdominal pain and constipation. She underwent concomitant caesarean section and laparotomy for intestinal obstruction. Intra-operatively, the sigmoid colon was extensively dilated and gangrenous. The ischemic colon was resected and a Hartmann’s procedure was performed. A preterm male child was delivered and admitted to neonatal intensive care. The post operative course was uneventful and the patient was discharged home on the 9th post-operative day. Six months later she underwent an uneventful reversal of the Hartmann’s procedure. Discussion Sigmoid volvulus is the most common cause of bowel obstruction during pregnancy, accounting for up to 44% of reported cases. We have reviewed the available literature on this topic and present another case managed at our institution. Conclusion Diagnosis of sigmoid volvulus in pregnancy is a challenge, but a delay in diagnosis increases the rates of feto-maternal mortality. A high incidence of clinical suspicion and timely surgical intervention are the key to a favourable outcome. |
| Databáze: | OpenAIRE |
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