Sigmoid Volvulus Presenting During Late Pregnancy: A Report of Two Cases from a Single Institution

Acute bowel obstruction is a rare but serious complication of pregnancy with substantial maternal and fetal morbidity and mortality. Early detection improves maternal and fetal outcomes and a high index of suspicion is necessary since many normal pregnancy-related symptoms may be similar, albeit milder, than those encountered in acute obstruction. Two cases of colon obstruction secondary to rectosigmoid volvulus occurring during the third trimester of pregnancy are presented. Unfortunately, one neonatal death occurred secondary to postoperative hemorrhage, fetoplacental hypoperfusion, and hypoxic encephalopathy. Each case of colon obstruction was readily identified by plain abdominal radiograph. Conventional imaging studies (particularly single-shot abdominal radiographs) do not pose a measurable teratogenic risk to the developing fetus and physicians should not hesitate to order appropriate imaging studies when acute obstruction is considered in the differential diagnosis.