Intestinal obstruction in pregnancy

a rare case of acute abdomen

Abstract

Transverse colon volvulus is a rare, serious cause of acute obstructive abdomen. During pregnancy, this pathology becomes even less prevalent. Bowel obstruction syndrome is defined by a set of signs and symptoms that commonly manifest as intense abdominal pain, cessation of stool elimination and flatus, and has several non-traumatic causes, including volvulus. However, due to pregnancy, this condition may present a variability or overlap of symptoms with early worsening, sometimes due to limitations related to diagnostic imaging tests during pregnancy and, consequently, late diagnosis. In addition, this diversity of symptoms and high incidence of abdominal pain in the general population make its diagnosis difficult and becomes an important factor for hospital admission and, in severe cases, evolves with high morbidity and mortality. Due to its pathophysiology, there is a high risk of progression to complications due to progressive colon ischemia, especially without adequate intervention, therefore, early diagnosis and the appropriate therapeutic approach, whether colonoscopy or surgery, are imperative. Thus, this study demonstrates a clinical case of obstructive acute abdomen due to volvulus of the transverse colon during pregnancy and the therapies employed, from decompression by colonoscopy to a subsequent surgical approach requiring intestinal resection.