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Coecal volvulus: An acute complication of pregnancy.

Narjis Y, Rabbani K, Largab S, Soumani A, Finech B, El Idrissi Dafali A - J Emerg Trauma Shock (2010)

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Affiliation: Department of General Surgery, Universitary Hospital Mohamed VI, Cadi Ayyad University, Marrakesh, Morocco.

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Sir, Volvulus of the coecum is an extremely rare cause of intestinal obstruction during pregnancy... During the restoration of digestive continuity conducted 2 months after the first intervention, the patient presented an exteriorized digestive fistula of the right flank... Volvulus of the coecum is an axial twist or a folding of the bowel upon its mesentery... This results in acute intestinal obstruction which may or may not be complicated by occlusion of the mesenteric vessels... Volvulus of the coecum is the second cause of colonic obstruction during pregnancy after sigmoid colon volvulus and its incidence in pregnancy is 1/2500–1/3500... The coecopexy technique has low rates of complication and recurrence rates of 0–8%... Surgical resection eliminates the possibility of recurrence and usually results in low morbidity and mortality... We could not perform anastomosis because we found purulent peritoneal fluid... We conclude that coecal volvulus is an uncommon cause of colonic obstruction in pregnancy... It is an emergency situation and diagnosis should be withheld quickly by physical examination and usually radiological investigations... Any delay in diagnosis may cause often maternal and fetal complications... The treatment is always surgical.

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Per operative views showing the necrotic coecum with no fixation
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Figure 0003: Per operative views showing the necrotic coecum with no fixation

Mentions: A tocolysis with parenteral beta agonists was started and the patient taken for emergency surgery. The surgical exploration found a necrotic volvulus of coecum and purulent peritoneal fluid confirming peritonitis. There was no peritoneal fixation on the coecum [Figures 2 and 3]. The gangrenous gut was resected and ileocolostomy done. The postoperative course was uneventful. During the restoration of digestive continuity conducted 2 months after the first intervention, the patient presented an exteriorized digestive fistula of the right flank. It dried up spontaneously after 3 weeks. The patient delivered a healthy infant weighing 3.1 kg at full term. The postpartum was uneventful.Figure 2


Coecal volvulus: An acute complication of pregnancy.

Narjis Y, Rabbani K, Largab S, Soumani A, Finech B, El Idrissi Dafali A - J Emerg Trauma Shock (2010)

Per operative views showing the necrotic coecum with no fixation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966589&req=5

Figure 0003: Per operative views showing the necrotic coecum with no fixation
Mentions: A tocolysis with parenteral beta agonists was started and the patient taken for emergency surgery. The surgical exploration found a necrotic volvulus of coecum and purulent peritoneal fluid confirming peritonitis. There was no peritoneal fixation on the coecum [Figures 2 and 3]. The gangrenous gut was resected and ileocolostomy done. The postoperative course was uneventful. During the restoration of digestive continuity conducted 2 months after the first intervention, the patient presented an exteriorized digestive fistula of the right flank. It dried up spontaneously after 3 weeks. The patient delivered a healthy infant weighing 3.1 kg at full term. The postpartum was uneventful.Figure 2

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Universitary Hospital Mohamed VI, Cadi Ayyad University, Marrakesh, Morocco.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Sir, Volvulus of the coecum is an extremely rare cause of intestinal obstruction during pregnancy... During the restoration of digestive continuity conducted 2 months after the first intervention, the patient presented an exteriorized digestive fistula of the right flank... Volvulus of the coecum is an axial twist or a folding of the bowel upon its mesentery... This results in acute intestinal obstruction which may or may not be complicated by occlusion of the mesenteric vessels... Volvulus of the coecum is the second cause of colonic obstruction during pregnancy after sigmoid colon volvulus and its incidence in pregnancy is 1/2500–1/3500... The coecopexy technique has low rates of complication and recurrence rates of 0–8%... Surgical resection eliminates the possibility of recurrence and usually results in low morbidity and mortality... We could not perform anastomosis because we found purulent peritoneal fluid... We conclude that coecal volvulus is an uncommon cause of colonic obstruction in pregnancy... It is an emergency situation and diagnosis should be withheld quickly by physical examination and usually radiological investigations... Any delay in diagnosis may cause often maternal and fetal complications... The treatment is always surgical.

No MeSH data available.


Related in: MedlinePlus