Introduction: Volvulus of the sigmoid colon in pregnancy is a rare and serious complication; prognosis depends on early diagnosis and appropriate surgical management. The high maternal-fetal morbidity is due to delayed diagnosis. Observation: We report a case of sigmoid colon volvulus in a 34-year-old multiparous woman. Her history includes chronic constipation; she has never undergone surgery and her pregnancy is currently being monitored. She was seen in emergency with abdominal pain, cessation of bowel movements and early gas, vomiting on a 26-week, 4-day amenorrhea, which had been evolving for 4 days. Obstetrical examination revealed an open cervix with endo uterine bleeding. The patient expelled a male fetus 2 hours after admission. An unprepared abdominal X-ray revealed a double-legged arch. The patient underwent surgery; the operative lesion being a 2-turn sigmoid volvulus with necrosis of the loop. The necrotic loop was resected and a Hartmann-type colostomy was performed; the peritoneal cavity was cleaned and drained. Results: Preoperative preparation of patients requires a collegial decision involving an obstetrician, a resuscitator-anesthetist and a surgeon, in order to discuss prophylactic tocolysis, corticosteroid therapy for fetal maturation and the surgical indication on a case-by-case basis. The standard surgical treatment is colectomy with restoration of colonic continuity, or colostomy if necrosis is present. Endoscopy is useful for emergency treatment of uncomplicated volvulus. Conclusion: diagnosis of sigmoid volvulus is difficult during pregnancy. It is a medical-surgical emergency requiring multidisciplinary management. The maternal-fetal prognosis depends on early diagnosis and rapid and adequate management. Standard surgical treatment is sigmoidectomy with immediate restoration of colonic continuity; in cases of necrosis, colostomy is indicated. Endoscopy is of vital importance in the emergency treatment of uncomplicated volvulus.
| Published in | Journal of Gynecology and Obstetrics (Volume 11, Issue 5) |
| DOI | 10.11648/j.jgo.20231105.11 |
| Page(s) | 111-114 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Sigmoid Volvulus, Pregnancy, Necrosis, Surgical Emergency
| [1] | Narjis Y, El Mansouri MN, Jgounni R, Louzi A, Abassi H, Soumani A et al. Sigmoid Volvulus, a rare complication of pregnancy. Gynecology Obstetrics & Fertility 2008; 36: 776-778. |
| [2] | Ashraf O, Peer S, Fayaz M, Dar MS, Illahi I, Shafi F. Sigmoid volvulus during second trimester of pregnancy in a primigravida: Report of a rare case with review of imaging of sigmoid volvulus. Int J Case Rep Images 2016; 7 (7): 436–440. |
| [3] | Atamanalp SS, Kisaoglu A, Ozogul B, Kantarci M, Disci E, Bulut OH et al. Sigmoid volvulus complicating pregnancy: a case report. Eurasian J Med 2015; 47 (1): 75–6. |
| [4] | Najih M, Abdellaoui M, Hafidi MR, Laraqui H, AlKandry S. L’occlusion intestinale aiguë gravidique. À propos de cinq cas. Pan African Medical Journal 2012; 11: 40. |
| [5] | Al Maksoud AM, Barsoum AK, Moneer MM. Sigmoid volvulus during pregnancy: A rare non-obstetric complication. Report of a case and review of the literature. Int J Surg Case Rep 2015; 17: 61–4. |
| [6] | Peterson CM, Anderson JS, Hara AK, Carenza JW, Menias CO. Volvulus of the gastrointestinal tract: appearances at multimodality imaging. Radiographics 2009; 29 (5): 1281–93. |
| [7] | Aftab Z, Toro A, Abdallah A, Dasovky M, Gehani S, Mola AA et al. Endoscopic reduction of a volvulus of the sigmoid colon in pregnancy: case report and a comprehensive review of the literature. World J Emerg Surg 2014; 9: 41. |
| [8] | Palmucci S, Lanza ML, Gulino F, Scilletta B, Ettorre GC. Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings. J Radiol Case Rep 2014; 8 (2): 54–62. |
| [9] | Serafeimidis C, Waqainabete I, Creaton A, Vakamacawai E, Kumar R. Sigmoid volvulus in pregnancy: case report and review of literature. Clinical Case Reports 2016; 4 (8): 759–761. |
| [10] | Chang YT, Huang YS, Chan HM, Chan HM, Huang CJ, Hsieh JS et al. Intestinal obstruction during pregnancy. Kaohsiung J Med Sci. 2006; 22 (1): 20-3. |
| [11] | Hamdoun F, Lahlali M, Bledou M, Lamine A, Abid H, Lahmidani N et al. Volvulus of the Sigmoid in Pregnancy: About A Case. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 2019; 18 (3): 66-68. |
| [12] | EL Bouhaddouti H, Slaoui MA, Lamrani J, Marjani M, Louchi A, Bouguern H et al. Volvulus du grêle et grossesse: A propos d’un cas. AMETHER2010; 2 (1): 49–52. |
| [13] | Kang HJ, Kim SH, Ryu JH, Choi SJ, Roh CR. A case of intussusception managed conservatively in pregnancy. J Womens Med. 2011; 4: 15-18. |
| [14] | Atamanalp SS, Disci E, Atamanalp RS. Sigmoid volvulus: Comorbidity with sigmoid gangrene. Pak J Med Sci. 2019; 35 (1): 288–290. |
| [15] | Khan MR, Ur Rehman S. Sigmoid volvulus in pregnancy and puerperium: a surgical and obstetric catastrophe. Report of a case and review of the world literature. World J Emerg Surg. 2012; 7: 10. |
APA Style
Naby Fofana, Ansoumane Condé, Massa Keïta, Alseny Diallo, Djiba Camara, et al. (2023). Volvulus of the Pelvic Colon in Pregnancy: A Case Report from the Surgical Department of the National Hospital of Ignace Deen, Teaching University of Conakry, Guinea. Journal of Gynecology and Obstetrics, 11(5), 111-114. https://doi.org/10.11648/j.jgo.20231105.11
ACS Style
Naby Fofana; Ansoumane Condé; Massa Keïta; Alseny Diallo; Djiba Camara, et al. Volvulus of the Pelvic Colon in Pregnancy: A Case Report from the Surgical Department of the National Hospital of Ignace Deen, Teaching University of Conakry, Guinea. J. Gynecol. Obstet. 2023, 11(5), 111-114. doi: 10.11648/j.jgo.20231105.11
AMA Style
Naby Fofana, Ansoumane Condé, Massa Keïta, Alseny Diallo, Djiba Camara, et al. Volvulus of the Pelvic Colon in Pregnancy: A Case Report from the Surgical Department of the National Hospital of Ignace Deen, Teaching University of Conakry, Guinea. J Gynecol Obstet. 2023;11(5):111-114. doi: 10.11648/j.jgo.20231105.11
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Download@article{10.11648/j.jgo.20231105.11,
author = {Naby Fofana and Ansoumane Condé and Massa Keïta and Alseny Diallo and Djiba Camara and Sandaly Diakité and Aminata Fofana and Alpha Mohamed Youla and Labile Togba Soumaoro and Aboubacar Touré},
title = {Volvulus of the Pelvic Colon in Pregnancy: A Case Report from the Surgical Department of the National Hospital of Ignace Deen, Teaching University of Conakry, Guinea},
journal = {Journal of Gynecology and Obstetrics},
volume = {11},
number = {5},
pages = {111-114},
doi = {10.11648/j.jgo.20231105.11},
url = {https://doi.org/10.11648/j.jgo.20231105.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20231105.11},
abstract = {Introduction: Volvulus of the sigmoid colon in pregnancy is a rare and serious complication; prognosis depends on early diagnosis and appropriate surgical management. The high maternal-fetal morbidity is due to delayed diagnosis. Observation: We report a case of sigmoid colon volvulus in a 34-year-old multiparous woman. Her history includes chronic constipation; she has never undergone surgery and her pregnancy is currently being monitored. She was seen in emergency with abdominal pain, cessation of bowel movements and early gas, vomiting on a 26-week, 4-day amenorrhea, which had been evolving for 4 days. Obstetrical examination revealed an open cervix with endo uterine bleeding. The patient expelled a male fetus 2 hours after admission. An unprepared abdominal X-ray revealed a double-legged arch. The patient underwent surgery; the operative lesion being a 2-turn sigmoid volvulus with necrosis of the loop. The necrotic loop was resected and a Hartmann-type colostomy was performed; the peritoneal cavity was cleaned and drained. Results: Preoperative preparation of patients requires a collegial decision involving an obstetrician, a resuscitator-anesthetist and a surgeon, in order to discuss prophylactic tocolysis, corticosteroid therapy for fetal maturation and the surgical indication on a case-by-case basis. The standard surgical treatment is colectomy with restoration of colonic continuity, or colostomy if necrosis is present. Endoscopy is useful for emergency treatment of uncomplicated volvulus. Conclusion: diagnosis of sigmoid volvulus is difficult during pregnancy. It is a medical-surgical emergency requiring multidisciplinary management. The maternal-fetal prognosis depends on early diagnosis and rapid and adequate management. Standard surgical treatment is sigmoidectomy with immediate restoration of colonic continuity; in cases of necrosis, colostomy is indicated. Endoscopy is of vital importance in the emergency treatment of uncomplicated volvulus.},
year = {2023}
}
TY - JOUR T1 - Volvulus of the Pelvic Colon in Pregnancy: A Case Report from the Surgical Department of the National Hospital of Ignace Deen, Teaching University of Conakry, Guinea AU - Naby Fofana AU - Ansoumane Condé AU - Massa Keïta AU - Alseny Diallo AU - Djiba Camara AU - Sandaly Diakité AU - Aminata Fofana AU - Alpha Mohamed Youla AU - Labile Togba Soumaoro AU - Aboubacar Touré Y1 - 2023/10/08 PY - 2023 N1 - https://doi.org/10.11648/j.jgo.20231105.11 DO - 10.11648/j.jgo.20231105.11 T2 - Journal of Gynecology and Obstetrics JF - Journal of Gynecology and Obstetrics JO - Journal of Gynecology and Obstetrics SP - 111 EP - 114 PB - Science Publishing Group SN - 2376-7820 UR - https://doi.org/10.11648/j.jgo.20231105.11 AB - Introduction: Volvulus of the sigmoid colon in pregnancy is a rare and serious complication; prognosis depends on early diagnosis and appropriate surgical management. The high maternal-fetal morbidity is due to delayed diagnosis. Observation: We report a case of sigmoid colon volvulus in a 34-year-old multiparous woman. Her history includes chronic constipation; she has never undergone surgery and her pregnancy is currently being monitored. She was seen in emergency with abdominal pain, cessation of bowel movements and early gas, vomiting on a 26-week, 4-day amenorrhea, which had been evolving for 4 days. Obstetrical examination revealed an open cervix with endo uterine bleeding. The patient expelled a male fetus 2 hours after admission. An unprepared abdominal X-ray revealed a double-legged arch. The patient underwent surgery; the operative lesion being a 2-turn sigmoid volvulus with necrosis of the loop. The necrotic loop was resected and a Hartmann-type colostomy was performed; the peritoneal cavity was cleaned and drained. Results: Preoperative preparation of patients requires a collegial decision involving an obstetrician, a resuscitator-anesthetist and a surgeon, in order to discuss prophylactic tocolysis, corticosteroid therapy for fetal maturation and the surgical indication on a case-by-case basis. The standard surgical treatment is colectomy with restoration of colonic continuity, or colostomy if necrosis is present. Endoscopy is useful for emergency treatment of uncomplicated volvulus. Conclusion: diagnosis of sigmoid volvulus is difficult during pregnancy. It is a medical-surgical emergency requiring multidisciplinary management. The maternal-fetal prognosis depends on early diagnosis and rapid and adequate management. Standard surgical treatment is sigmoidectomy with immediate restoration of colonic continuity; in cases of necrosis, colostomy is indicated. Endoscopy is of vital importance in the emergency treatment of uncomplicated volvulus. VL - 11 IS - 5 ER -
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