Cecal volvulus during pregnancy. Case report

Area of Science:

• Obstetrics and Gynecology
• Gastroenterology
• Surgical Case Reports

Background:

• Acute intestinal obstruction during pregnancy presents a significant risk, with high rates of maternal and fetal mortality.
• Cecal volvulus is an uncommon yet life-threatening cause of intestinal obstruction in pregnant individuals.

Observation:

• A 20-year-old gravida presented with symptoms of acute abdomen, including vomiting, constipation, and abdominal pain, progressing to septic shock.
• Diagnostic imaging revealed distended bowel loops, free peritoneal fluid, and colonic air-fluid levels, while the fetus was diagnosed as non-viable in utero.
• Laparotomy confirmed complete cecal volvulus with gangrene, necessitating a right hemicolectomy and ileotransverse anastomosis.

Findings:

• The surgical intervention included a right hemicolectomy and side-to-side ileotransverse anastomosis for cecal volvulus.
• A cesarean section was performed, resulting in the delivery of a stillborn fetus.
• The patient recovered well post-operatively and was discharged on the ninth day.

Implications:

• Cecal volvulus during pregnancy is a rare surgical emergency that can be challenging to diagnose pre-operatively.
• Timely diagnosis and surgical management are critical to reduce maternal and fetal mortality associated with this condition.
• This case highlights the importance of prompt surgical exploration in pregnant patients with suspected acute abdominal emergencies.