Uterine Rotation: A Cause of Intestinal Obstruction

Abstract

Intestinal obstruction is an uncommon surgical emergency during pregnancy that affects seriously the prognosis of gestation. The underlying cause can be identified in the majority of cases and usually consists of adhesions secondary to previous abdominal or pelvic surgery, followed in order of frequency by intestinal volvuli. In recent years there have been no reports in which the gravid uterus has been the cause of intestinal obstruction. We report the case of a woman in week 33 + 4 of pregnancy who developed extrinsic compression of the colon secondary to uterine rotation and pelvic impaction of the head of the fetus.

Impingement by a polymyomatous uterus: a rare cause of large bowel obstruction

“…A polymyomatous uterus such as in our case has been reported previously, though this was complicated by a ruptured tubal ectopic pregnancy, which may have contributed to the obstruction [ 7 ]. The remainder of the obstructions were in normal but pregnant uteri, ranging from 16 weeks to 35 weeks gravidity [ 3 , 4 , 8 , 9 ]. Two of the pregnancies were complicated, one with a detroflexed uterus, another holding a triple pregnancy [ 8 , 9 ].…”

“…The remainder of the obstructions were in normal but pregnant uteri, ranging from 16 weeks to 35 weeks gravidity [ 3 , 4 , 8 , 9 ]. Two of the pregnancies were complicated, one with a detroflexed uterus, another holding a triple pregnancy [ 8 , 9 ]. A normal uterus 2 days post LSCS was also shown to cause bowel obstruction.…”

“…Intraoperatively, the large bowel was found to be dilatated up to the point where the sigmoid colon crossed the pelvic brim, resolving the moment the uterus was mobilized [ 3–5 , 7–9 ]. Although these laparotomies did not find surgical pathology, some patients still underwent an unplanned Caesarean section, abortion or hysterectomy as a result [ 4 , 5 , 9 ]. With increased awareness of this condition, and early diagnosis on imaging, we hope that future cases will be able to be avoid these unwanted outcomes.…”