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Recurrent sigmoid volvulus in pregnancy A 23-year-old, gravida 3 para 2, presented to the emergency room at 36 +5 weeks gestation with a 3-day history of cramping abdominal pain, distension and obstipation. She had a previous history of sigmoid volvulus at 5 weeks gestation, which after initial diagnosis with a magnetic resonance imaging scan (Fig. 1), was treated successfully with endoscopic decompression. On examination, her abdomen was distended, tympanic and mildly tender to palpation, but without peritonitis. A clinical diagnosis of sigmoid volvulus was made based on her previous history. An urgent abdominal X-ray was performed. The X-ray demonstrated enlarged and twisted loops of bowel with a classical ‘coffee-bean’ sign, consistent with a sigmoid volvulus (Fig. 2). She underwent rigid sigmoidoscopy with partial decompression of the volvulus on the second attempt and successful placement of a rectal tube. The gravid uterus would not allow complete decompression of the volvulus and in the clinical context, a joint decision to induce labour was made by the surgical and obstetric teams, with spontaneous vaginal delivery of a healthy baby 15 h later (
Recurrent sigmoid volvulus in pregnancy A 23-year-old, gravida 3 para 2, presented to the emergency room at 36 +5 weeks gestation with a 3-day history of cramping abdominal pain, distension and obstipation. She had a previous history of sigmoid volvulus at 5 weeks gestation, which after initial diagnosis with a magnetic resonance imaging scan (Fig. 1), was treated successfully with endoscopic decompression. On examination, her abdomen was distended, tympanic and mildly tender to palpation, but without peritonitis. A clinical diagnosis of sigmoid volvulus was made based on her previous history. An urgent abdominal X-ray was performed. The X-ray demonstrated enlarged and twisted loops of bowel with a classical ‘coffee-bean’ sign, consistent with a sigmoid volvulus (Fig. 2). She underwent rigid sigmoidoscopy with partial decompression of the volvulus on the second attempt and successful placement of a rectal tube. The gravid uterus would not allow complete decompression of the volvulus and in the clinical context, a joint decision to induce labour was made by the surgical and obstetric teams, with spontaneous vaginal delivery of a healthy baby 15 h later (
