Sigmoid volvulus in pregnancy

Aim: 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 fi rst- 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.