Sigmoid volvulus in pregnancy

To review the clinical outcomes of 9 patients with sigmoid volvulus (SV), a rare complication during pregnancy. Materials and methods: The clinical records of the patients were reviewed retrospectively. Results: The age range of the patients was 24-39 years (mean: 30.6 years). All patients were multiparous, and 6 patients (66.7%) were in the third trimester when diagnosed with SV. The main clinical features were abdominal pain/tenderness, obstipation, and distention in all patients (100.0%). The correct diagnosis was achieved based on clinical examination in 66.7% of the cases. Endoscopic detorsion was attempted in 6 patients (66.7%), with an 83.3% success rate. Emergency surgery was required in 4 patients (44.4%) and resulted in 25.0% surgical mortality and morbidity rates. Conclusion: SV during pregnancy is generally seen in multiparous women in the third trimester. The typical clinical presentation involves a triad of abdominal pain, distension, and constipation. Flexible endoscopic detorsion is the first-line treatment in the absence of peritonitis or bowel gangrene. For gangrenous cases, emergent sigmoid resection with diverting colostomy or primary anastomosis is performed, and surgical detorsion is reserved for nongangrenous cases. Effective resuscitation and prompt treatment improve the generally poor prognosis.

Sigmoid volvulus in pregnancy

To review the clinical outcomes of 9 patients with sigmoid volvulus (SV), a rare complication during pregnancy. Materials and methods: The clinical records of the patients were reviewed retrospectively. Results: The age range of the patients was 24-39 years (mean: 30.6 years). All patients were multiparous, and 6 patients (66.7%) were in the third trimester when diagnosed with SV. The main clinical features were abdominal pain/tenderness, obstipation, and distention in all patients (100.0%). The correct diagnosis was achieved based on clinical examination in 66.7% of the cases. Endoscopic detorsion was attempted in 6 patients (66.7%), with an 83.3% success rate. Emergency surgery was required in 4 patients (44.4%) and resulted in 25.0% surgical mortality and morbidity rates. Conclusion: SV during pregnancy is generally seen in multiparous women in the third trimester. The typical clinical presentation involves a triad of abdominal pain, distension, and constipation. Flexible endoscopic detorsion is the first-line treatment in the absence of peritonitis or bowel gangrene. For gangrenous cases, emergent sigmoid resection with diverting colostomy or primary anastomosis is performed, and surgical detorsion is reserved for nongangrenous cases. Effective resuscitation and prompt treatment improve the generally poor prognosis.

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  • Lord SA, Boswell WC, Hungerpiller JC. Sigmoid volvulus in pregnancy. Am Surg 1996; 62: 380-2.
  • Ballantyne GH, Brandner MD, Beart RW Jr, Ilstrup DM. Volvulus of the colon. Incidence and mortality. Ann Surg 1985; 202: 83-92. 3. Narjis Y, El Mansouri MN, Jgounni R, Louzi A, Abassi H, Soumani A et al. Sigmoid volvulus, a rare complication of pregnancy. Gynecol Obstet Fert 2008; 36: 776-8.
  • Iwamoto I, Miwa K, Fujino T, Douchi T. Perforated colon volvulus coiling around the uterus in a pregnant woman with a history of severe constipation. J Obstet Gynaecol Res 2007; 33: 731-3. 5. Raveenthiran V, Madiba TE, Atamanalp SS, De U. Volvulus of the sigmoid colon. Colorectal Dis 2010; 12: e1-e17. doi: 10.1111/j.1463-1318.2010.02262.x. 6. Atamanalp SS. Sigmoid volvulus. EAJM 2010; 42: 144-9.
  • Tegegne A. Cultural bowel patterns and sex diff erence in sigmoid volvulus morbidity in an Ethiopian hospital. Trop Geogr Med 1995; 47: 212-5. 8. Perdue PW, Johnson HW Jr, Staff ord PW. Intestinal obstruction during pregnancy. Am J Surg 1992; 164: 384-8. 9. Allen JC. Sigmoid volvulus in pregnancy. J R Army Med Corps 1990; 136: 55-6.
  • Vo TM, Gyaneshwar R, Mayer C. Concurrent sigmoid volvulus and herniation through broad ligament defect during pregnancy: case report and literature review. J Obstet Gynaecol 2008; 34: 658-62.
  • Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Basoglu M, Polat KY et al. An algorithm for the management of sigmoid colon volvulus and the safety of primary resection: experience with 827 cases. Dis Colon Rectum 2007; 50: 489-97.
  • Heis HA, Bani-Hani KE, Rabadi DK, Elheis MA, Bani-Hani BK, Mazahreh TS et al. Sigmoid volvulus in the Middle East. World J Surg 2008; 32: 459-64.
  • Connolly MM, Unti JA, Nora PF. Bowel obstruction in pregnancy. Surg Clin North Am 1995; 75: 101-13.
  • De U, De KK. Sigmoid volvulus complicating pregnancy. Indian J Med Sci 2005; 59: 317-9.
  • Dua RS, Rothnie ND, Gray EA. Sigmoid volvulus in the puerperium. Int J Gynecol Obstet 2007; 97: 195-208.
  • Alshawi JS. Recurrent sigmoid volvulus in pregnancy: report of a case and review of the literature. Dis Colon Rectum 2005; 48: 1811-3.
  • Mirza MS, Mulla M, Hall RI. Large bowel obstruction in pregnancy: a rare entity, an unusual cause. Arch Gynecol Obstet 2009; 279: 177-8.
  • Kolusari A, Kurdoglu M, Adali E, Yildizhan R, Sahin HG, Kotan C. Sigmoid volvulus in pregnancy and puerperium: a case series. Cases J 2009; 2: 9275.
  • Lurie S, Katz Z, Rabinerson D, Simon D. Sigmoid volvulus aft er medical management with subsequent operative laparoscopy of unruptured ectopic pregnancy. Gynecol Obstet Invest 1997; 43: 204-5.
  • Hofmeyr GJ, Sonnendecker EWW. Sigmoid volvulus in advanced pregnancy. Report of 2 cases. S Afr Med J 1985; 67: 63-4.
  • Atamanalp SS, Ören D, Aydınlı B, Öztürk G, Polat KY, Başoğlu M et al. Elective treatment of detorsioned sigmoid volvulus. Turk J Med Sci 2008; 38: 227-34.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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Sigmoid volvulus in pregnancy

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