Gangrenous Sigmoid Volvulus in a Complicated Pregnancy: An Alarming Obstetric and Surgical Stigmata

Sigmoid volvulus in pregnancy is a rare presentation, since 1885, only 104 cases have been documented. Due to pregnancy, especially in last trimester, any clinical presentation of acute abdomen is easily masked by the growing fetus. Rather then, delayed diagnosis results in perforation and gangrenous SV which is disastrous to both, mother and unborn child. It presents with either typical or atypical symptoms. Furthermore, avoidance of radiological studies and sticking to obstetrics ultrasonography ultimately make such cases more complicated. In this case, a 24 years old, hepatitis C pregnant woman, who presented with the pre-eclampsia in early 3rd trimester is being documented in developing countries like Pakistan for the first time. Due to physiological changes in pregnancy, other clinical conditions and unique presentation of the patient, her intestinal obstruction was clouded. A little delay might have threatened the patient's life but frequent gut decompression followed by surgery saved her. This study reports a case of atypical presentation of Sigmoid volvulus in 3rd trimester, 24 years old pregnant woman with satisfactory outcomes.