Small bowel obstruction in pregnancy.
BACKGROUND
Intestinal obstruction in pregnancy is rare. Symptoms are often unspecific and a high level of suspicion is essential for early diagnosis. Fetal and maternal mortality rates are higher during pregnancy due to delay in diagnosis.


METHODS
A 31-year-old primigravida with a history of abdominal surgery was admitted because of worsening abdominal pain, abdominal distension and elevated pancreatic enzymes. Ultrasound showed dilated small bowel loops. Explorative laparotomy revealed a small bowel obstruction with partial bowel necrosis caused by a single adhesion. A jejuno-jejunostomy was performed. Five days later, she developed peritonitis. A secondary laparotomy and caesarean section were done.


CONCLUSIONS
In spite of timely diagnosis and prompt surgical intervention, our case was still complicated by peritonitis and early delivery. This underlines the necessity of immediate clinical suspicion. Small bowel obstruction should be considered in differential diagnosis of pregnant patients with a history of abdominal surgery.
Redlich
Anke
A
University Women's Clinic, Otto-von-Guericke University, Gerhart-Hauptmann-Strasse 35, 39108 Magdeburg, Germany. Serban-Dan.Costa@Medizin.Uni-Magdeburg.DE
Rickes
Steffen
S
Costa
Serban-Dan
SD
Wolff
Stefanie
S
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000681:Amylases / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D007582:Jejunostomy; D008049:Lipase / Q000097:blood; D009336:Necrosis; D010538:Peritonitis / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000601:surgery; D000637:Transaminases / Q000097:blood
D002097:C-Reactive Protein; D000637:Transaminases; D008049:Lipase; D000681:Amylases