07/03/2026
Sigmoid volvulus during early pregnancy is rare and presents unique diagnostic and therapeutic challenges. We report the case of a 7-week gestation patient with recurrent sigmoid volvulus. Diagnosis was confirmed by MRI abdomen to avoid fetal radiation exposure. Initial management included colonoscopic decompression on two occasions; however, volvulus recurred.
Given persistent recurrence and progressive colonic dilatation, surgical intervention was planned. During laparoscopy, significant sigmoid distension necessitated intraoperative decompression using colonoscopy to facilitate safe handling and visualization. Considering the patient’s strong desire to continue the pregnancy, bowel resection was deliberately avoided to minimize risks associated with resection and anastomosis in early gestation.
A laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon was performed as a fertility-preserving and pregnancy-safe alternative. The postoperative course was uneventful. On follow-up, the patient remained asymptomatic with no recurrence of volvulus, and postoperative obstetric evaluation confirmed a viable intrauterine pregnancy with healthy fetal development.
This case highlights laparoscopic sigmoidopexy with extraperitonealization as a safe and effective option for recurrent sigmoid volvulus in the first trimester of pregnancy when resection is best avoided.
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