Concurrent sigmoid volvulus and herniation through broad ligament defect during pregnancy: case report and literature review.
Sigmoid volvulus in pregnancy is a rare complication. The combination of sigmoid volvulus and sigmoid herniation through a broad ligament together with placental abruption in pregnancy is a most unusual obstetrical emergency. We report the case of a previously well 32-year-old Mexican woman who was transferred to our institution at 28 weeks gestation with threatened preterm labor. We considered the possibility of appendicitis. While awaiting a surgical consult, an emergency cesarean section was carried out for a prolonged deceleration of the fetal heart. A routine transverse suprapubic abdominal entry revealed a large loop of ischemic bowel. This was confirmed to be a sigmoid volvulus which had herniated through a left broad ligament defect. The deceleration was attributed to a large placental abruption. No previous case with a combination of a sigmoid volvulus and placental abruption was found in the literature.
O & G Department, Liverpool Hospital, Liverpool, New South Wales, Australia. thimong.vo@swsahs.nsw.gov.au
Thi M
TM
Vo
Rajat
R
Gyaneshwar
Christiane
C
Mayer
D000037:Abruptio Placentae / Q000473:pathology / Q000601:surgery*; D000328:Adult; D001956:Broad Ligament / Q000473:pathology*; D012809:Colon, Sigmoid / Q000473:pathology; D005260:Female; D046449:Hernia, Abdominal / Q000209:etiology* / Q000473:pathology; D006801:Humans; D045822:Intestinal Volvulus / Q000150:complications* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D012810:Sigmoid Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery