Female pt 38 year old Presented with constipation and abdominal distension She is pregnant with previous two c/s. What is the diagnosis? Sent by a colleague. Dedos

Continuation She was diagnosed as Oglive's syndrome by U/S and CT Managed conservatively with neostigmine, improved for 4 days then she developed constipation, massive abd distention and sever pain. Gynecology consultation was done regarding the case and the possibility of pregnancy termination. The gynecologist accepted to terminate the pregnance if the pain resolved. The patien was deteriorating so exploration surgery was performed as illustrated throughout the video. After the surgery she was addmited to the icu, then transferred to the ward two days after, and discharged in a good health with normal bowel.

@MAdarosy Sigmoid volvulus (coffee bean sign) 📸 Picture Reference: Radiopaedia

@MAdarosy Sigmoid Volvulus Did not have enough space So wrote down in my notes and pasting it here 🙂 Image on Rt: NEJM

@MAdarosy The most likely diagnosis for a 38-year-old pregnant patient with constipation and abdominal distension, who has a history of two previous cesarean sections, is bowel obstruction due to adhesions from the prior surgeries.

@MAdarosy DDx: Acute Megacolon Causes: Chronic Constipation, Obstructive Causes (Volvulus).

@MAdarosy Ogilvie syndrome؟

@MAdarosy Sigmoid volvulus (coffee bean sign)

@MAdarosy Intestinal Obstruction secondary to adhesion

@MAdarosy That man behind i don't if he is anaesthetist/Anaesthesiologist have neither mask nor cap!!🥺

@MAdarosy Volvulus...??