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), 2023. Published by Science Publishing Group |
Sigmoid Volvulus, Pregnancy, Necrosis, Surgical Emergency
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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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