Sigmoid volvulus in pregnancy: early diagnosis and intervention are important

Ahmad, Anis; Shing, Koh Kai; Tan, Khim Khee; Krasu, Mary; Bickle, Ian; Chong, Vui Heng

doi:10.1016/j.ajem.2013.11.024

Cited by 8 publications

(11 citation statements)

References 5 publications

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“… Etiological relation with endoscopy? Sigmoidoscopy IBD & colitis other [ 36 - 41 ] 8 (in 6 pts) None (n = 6) Live birth (n = 5), not reported (n = 1) Yes (n = 1), no (n = 4), not reported (n = 1) Low birth weight (n = 2), not reported (n = 1) No No Malignancy [ 42 - 47 ] 6 Maternal death (n = 2), unreported (n = 1), none (n = 3) Live birth (n = 3), elective abortion (n = 2), fetal death (n = 1) Yes (n = 3) all prostaglandin induced or elective caesarean section Low birth weight (n = 3) Yes (n = 3), no (n = 3) Unlikely (n = 3) Volvulus and incarcerated uterus [ 19 , 48 , 49 ] 7 (in 5 pts) None Live birth (n = 5) None Low birth weight (n = 1) No No Non-malignant colonic obstruction [ 50 ] 1 None Live birth (n = 1) Yes (n = 1) Vaginal delivery at 35 wks No No Gastrointestinal bleeding [ 51 ] 1 None Stillbirth (n = 1) Yes (n = 1) Fetal demise at 20 wks within several hours of surgery Yes Possible, however the patient also underwent emergency surgery and suffered from a massive hemorrhage Colonoscopy IBD & colitis other [ 24 , 52 - 54 ] 6 None Live birth (n = 5), stillbirth (n = 1) Yes(n = 2), No (n = 4) Unreported (n = 2), none (n = 4) Unclear, paper fails to show which outcome belongs to which patient Unclear, authors do not link adverse event (stillbirth) to endoscopy Malignanc...…”

Section: Resultsmentioning

confidence: 99%

“… Sigmoidoscopy IBD & colitis other [ 11 , 64 , 65 ] 3 None (n = 2), subtotal colectomy with ileostomy after delivery (n = 1) Live birth (n = 3) No (n = 1), Yes (n = 2) Premature births (28 and 34 wks), low birth weight (1850 and 1054 g) No (n = 2), yes (n = 1) Likely, after sigmoidoscopy colonic perforation was suspected, this led to an emergency caesarean section. Malignancy [ 66 - 70 ] 5 Not reported (n = 3), death 12 months after hemicolectomy (n = 1), 1,5 years after delivery discovery of pulmonary metastases (n = 1) Live birth (n = 5) Yes (n = 4), No (n = 1) Premature births at 34, 34, 31 and 33 wks, all deliveries were elective, low birth weight reported (n = 2) No Unlikely Volvulus and incarcerated uterus [ 49 , 71 - 73 ] 5 (in 4 pts) None Live birth (n = 4) None None Yes (n = 1) Unlikely Non-malignant colonic obstruction [ 74 , 75 ] 2 None Live birth (n = 1), not reported (n = 1) Yes (n = 1) Elective caesarean section (n = 1), Not reported (n = 1) Yes (n = 1) Unlikely Gastrointestinal bleeding 0 - - - - - - Colonoscopy IBD & colitis other [ 52 , 76 ] 2 Intensive care unit admittance postpartum (n = 1), none (n = 1) Live birth (n = 1), not reported (n = 1) Yes (n = 1), not reported (n = 1) Premature birth (32 wks) with low birth weight 2175 grams No Unlikely Malignancy [ …”

Section: Resultsmentioning

confidence: 99%

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Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? – a systematic review

et al. 2015

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BackgroundGastrointestinal endoscopy plays a crucial role in the diagnosis and management of gastrointestinal disorders. When endoscopy is indicated during pregnancy, concerns about the effects on pregnancy outcome often arise. The aim of this study was to assess whether lower gastrointestinal endoscopies (LGEs) across all three trimesters of pregnancy affects pregnancy outcomes.MethodsA systematic literature search was performed using Embase (including MEDLINE), Medline OvidSP, Cochrane Central Register of Controlled Trials, Web-of-Science, Google scholar and Pubmed. All original research articles from 1990 until May 2014 involving pregnant women who underwent LGE for any indication were included. Adverse pregnancy events like spontaneous abortion, preterm birth and fetal demise were assessed for a temporal and etiological relation with the LGE.ResultsIn total, 5514 references were screened by two independent reviewers. Eighty-two references met the inclusion criteria and were selected. Two retrospective, controlled studies, one uncontrolled study and 79 case reports were identified. In the three studies, birth outcomes did not differ between women undergoing LGE during pregnancy, compared to women that had an indication for LGE but in whom LGE was not performed because of pregnancy. In 79 case reports, 92 patients are described who underwent 100 LGE’s during pregnancy. LGEs performed in all trimesters (n = 32, 39 and 29) were both temporally and etiologically related to 1, 3 and 2 adverse events, respectively.ConclusionBased on the available literature, this review concludes that lower gastrointestinal endoscopy during pregnancy is of low risk for mother and child in all three trimesters of pregnancy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-015-0244-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? – a systematic review

et al. 2015

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“…Sigmoid volvulus is the most frequent site, followed by cecum, ascending colon, and transverse colon ( 5 ) . Khan et al found 84 cases in their latest review of the literature, whereas Ahmed reported fewer than 90 cases ( 6 , 7 ) .…”

Section: Discussionmentioning

confidence: 99%

Pregnancy with sigmoid volvulus: A case report with literature review

Dhar

Ahuja

Nimre

et al. 2015

tjod

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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.

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“…In no case will it be considered to break the vicious circle of abdominal surgery, adhesion, occlusion, abdominal surgery When the occlusion is colon-embedded, endoscopic treatment (untwisting or sten insertion) may be considered to prepare better conditions for surgery. 5,7,8 Prior to the collaborative intervention the College of Specialists discuss prophylactic tocolysis as was the case in two of our patients, corticosteroid therapy (third trimester lung maturation) and surgical indication. It must be borne in mind that the life of the mother takes precedence over that of the child.…”

Section: 4mentioning

confidence: 98%

“…[2][3][4][5] Diagnostic wandering and reluctance of some practitioners to seek radiative exploration frequently engages the foeto-maternal prognosis. 2,4,[6][7][8] Management should involve the visceral surgeon, obstetrician, resuscitation anesthesiologist and radiologist. 2,6,9 This collegiate care can be a source of conflict when the lives of the child and the mother have to be preserved.…”

Section: Introductionmentioning

confidence: 99%

Surgical and medical management of 05 cases of acute intestinal obstruction on pregnancy in university hospital center of Treichville, Côte d’Ivoire

et al. 2018

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From January 2003 to December 2017, the authors report five cases of acute intestinal obstruction during pregnancy. Two of them were received in digestive and proctological surgery emergencies. The other three patients were received urgently from the obstetrics and gynecology department. This association is a rare event. Clinical polymorphism delays the therapeutic management. In 1/5 cases only the diagnosis of occlusion on pregnancy was made. In 2/5 of the cases the diagnosis of occlusion was made and that of the pregnancy which at the 1st trimester was unknown. In last 2/5 of cases the pregnancies were at the 3rd trimester, the diagnosis of occlusion during pregnancy was made intraoperatively; Caesarean section being indicated for the fetal in distress on probable urinary tract infection. Authors did not have any maternal-fetal deaths. Through five cases of this association and a review of the literature, authors highlight the diagnostic and therapeutic difficulties and the therapeutic attitudes likely to improve the feto-maternal prognosis. This fetal prognosis depends essentially on the age of the pregnancy and the speed of the management.

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Sigmoid volvulus in pregnancy: early diagnosis and intervention are important

Cited by 8 publications

References 5 publications

Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? – a systematic review

Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? – a systematic review

Pregnancy with sigmoid volvulus: A case report with literature review

Surgical and medical management of 05 cases of acute intestinal obstruction on pregnancy in university hospital center of Treichville, Côte d’Ivoire

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