title: Small bowel obstruction in pregnancy.
abstract: 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.
authors.affiliation: University Women's Clinic, Otto-von-Guericke University, Gerhart-Hauptmann-Strasse 35, 39108 Magdeburg, Germany. Serban-Dan.Costa@Medizin.Uni-Magdeburg.DE
authors.forename: Anke
authors.initials: A
authors.lastname: Redlich
authors.forename: Steffen
authors.initials: S
authors.lastname: Rickes
authors.forename: Serban-Dan
authors.initials: SD
authors.lastname: Costa
authors.forename: Stefanie
authors.initials: S
authors.lastname: Wolff
mesh_terms: 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
chemical_list: D002097:C-Reactive Protein; D000637:Transaminases; D008049:Lipase; D000681:Amylases