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Ginecología y obstetricia de México
versão impressa ISSN 0300-9041
Resumo
GONZALEZ-SALAZAR, Esteban Agustín et al. Recurrent colonic volvulus in pregnancy: endoscopic treatment. Ginecol. obstet. Méx. [online]. 2021, vol.89, n.3, pp.274-278. Epub 11-Fev-2022. ISSN 0300-9041. https://doi.org/10.24245/gom.v89i3.4553.
BACKGROUND:
Intestinal occlusion during pregnancy is rare and involves high fetal and maternal mortality, generally associated with delayed diagnosis. One of the causes is colonic volvulus, almost always associated with elderly prostrate patients.
CLINICAL CASE:
A 32-year-old patient with a history of laparoscopic left colectomy for dolichomegasigma, in the thirtieth week of pregnancy. She came to the emergency room with colicky abdominal pain and vomiting. Ultrasound showed free fluid and colonic distension. CT scan raised the suspicion of a colonic volvulus. Videocolonoscopy was effective in resolving the picture. The pregnancy continued without further intercurrences and was terminated at 40 weeks by elective cesarean section, with no complications for the mother or the newborn.
CONCLUSIONS:
Colon volvulus is exceptional during pregnancy. Its diagnosis represents a challenge because the symptoms are similar to those of pregnancy; in addition, there is no consensus on the best diagnostic study. The physician must be suspicious of its possibility. Endoscopic remediation is a good option in the absence of peritoneal symptoms or fetal distress.
Palavras-chave : Intestinal occlusion; Intestinal obstruction; Volvulus; Colonic volvulus; Pregnancy; Laparoscopic; Colectomy; Abdominal pain; Ultrasonography.