Abstract
A 32-year-old pregnant woman complained of intermitted abdominal pain since 20 weeks gestation. Her pregnancy had been otherwise uneventful. At 25 weeks and 5 days of pregnancy, she was seen in our emergency room ; because of sever constipation with no bowel movement during the preceding 10 days and worsening abdominal pain. On abdominal X-ray, the sigmoid colon was markedly distended and presented coffee bean sign. We diagnosed this case to be sigmoid volvulus and inserted an ileus tube by the transanal route. On the following day, her abdominal distention improved, but whenever she resumed her diet, volvulus relapsed. We needed to insert an ileus tube six times in total. Although it was difficult, she continued the pregnancy until fetal maturity and gave birth, while continuing with conservative therapy. Finally a cesarean section and sigmoid colon resection were performed at 31 weeks 3 days of gestation. Both mother and infant were doing well after surgery.
Sigmoid volvulus in pregnancy is relatively rare, but it leads to death of the mother and fetus without proper diagnosis. We should select proper treatments to protect their health when diagnose pregnant woman as this.
