Pregnancy with sigmoid volvulus: A case report with literature review

Abstract

Sigmoid volvulus refers to torsion of a segment of the alimentary tract, which often leads to bowel obstruction and ischemic changes. Sigmoid volvulus is an acute surgical emergency because delay in diagnosis and management can cause adverse maternal and fetal complications. Sigmoid volvulus typically presents with acute-on-chronic abdominal distension that may develop slowly over 3-4 days. An early and effective resuscitation with fluid replacement, electrolyte balance correction, prophylactic antibiotics and nasogastric decompression is necessary. The standard goals of treatment are to relieve the obstruction, avoid colonic ischemia, and prevent recurrence either by endoscopic decompression or resection with primary anastomosis. A pregnant woman with sigmoid volvulus at 34 weeks and 1 day of gestation presented to our hospital with abdominal pain, vomiting, and constipation. The patient was jointly surgically managed with laparotomy, cesarean section, and detorsion of the sigmoid volvulus, and was discharged in a healthy state on the 5th postoperative day.

To Assess the Incidence and Factors Predisposing to Surgical Site Infection (SSI) in Patients Who Have Undergone Caesarean Section in Tertiary Care Hospital of Udupi District, Karnataka- A Retrospective Study

“…The overall study concluded that to reduce the number surgical site infection and prevent the risk factors it is necessary to maintain aseptic surgeries, implement infection prevention practices and give antibiotic prophylaxis to reduce morbidity in women undergoing caesarean section. 4 Farret, Dalle, Monteiro, Wurdig Riche, & Antonello (2015) conducted a retrospective case-control observational study that was conducted in Femina hospital in Porto Alegre, Brazil to determine the risk factors and impact of antibiotic prophylaxis for surgical site infection on caesarean section. A total number of 8180 caesarean section records were reviewed and 118 (1.44%) were diagnosed as having surgical site infection.…”

Management of sigmoid volvulus during labor : a challenging situation

“…It depends on the gestational age, the viability of the fetus, and the degree of intestinal necrosis. In the absence of peritoneal signs or mucosal ischemia, a detorsion and decompression via sigmoidoscopic placement of a soft rectal tube are a reasonable approach 9 . However, it seems that during the third trimester, colonoscopic detorsion is less successful among pregnant women compared to the rest of the patients.…”

Endoscopic Decompression of Recurrent Sigmoid Volvulus in Pregnancy

“…In pregnant patients, endoscopic decompression can be difficult to achieve due to progressive uterine enlargement. 13 Successful multiple endoscopic interventions during pregnancy have been reported and are becoming the preferred method to relieve obstruction but are still very uncommon since less than 10 cases of recurrent SV in the same pregnancy have been des cribed. 3,4,11,14,15 In the absence of acute perforation or ischemia, definitive operative treatment with elective colon resection with primary anastomosis is recommended after resolution of the acute volvulus phase to prevent recurrence.…”