Complete small-bowel volvulus complicating the second trimester

Volvulus is the second most common cause of intestinal obstruction in pregnancy. Rarely is the small bowel involved, and even less frequently is the volvulus complete.

The patient was referred at 24 weeks and 4 days' gestation for persistent anorexia, emesis, and abdominal distention. History, physical examination, and abdominal radiographs were consistent with a complete small-bowel obstruction. Laparotomy revealed two adhesive bands, which were lysed, and a 360 degrees volvulus of the small bowel about its mesentery, which was successfully reduced.

This patient represents a case of complete small-bowel volvulus successfully treated in the second trimester by detorsion.