Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings

J Radiol Case Rep. 2014 Feb 1;8(2):54-62. doi: 10.3941/jrcr.v8i2.1766. eCollection 2014 Feb.

Abstract

Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging.

Keywords: Intestinal Diseases; Magnetic Resonance Imaging; Pregnancy Complications; Ultrasonography; Volvulus.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Colon, Sigmoid / diagnostic imaging*
  • Colon, Sigmoid / pathology*
  • Colon, Sigmoid / surgery
  • Colonic Diseases / diagnosis*
  • Colonic Diseases / etiology
  • Colonic Diseases / surgery
  • Diagnosis, Differential
  • Female
  • Humans
  • Intestinal Volvulus / diagnosis*
  • Intestinal Volvulus / etiology
  • Intestinal Volvulus / surgery
  • Magnetic Resonance Imaging*
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / etiology
  • Pregnancy Complications / surgery
  • Ultrasonography