Small bowel infarction secondary to volvulus during pregnancy: a case report.
BACKGROUND
Pregnancy masks the signs and symptoms of intestinal obstruction. A high index of suspicion is required for proper and timely diagnosis.


METHODS
A 26-year-old, primiparous woman, 32 weeks pregnant, presented with a 1-day history of pain in the upper abdomen. The pain was sudden in onset and was mostly in the epigastric region. Initially the patient was managed conservatively on the suspicion of gastritis, but she did not respond. Subsequent abdominal ultrasound suggested intestinal obstruction. The decision for laparotomy was made. On entering the abdominal cavity, examination of the intestine revealed volvulus of the jejunum with a complete twist at the base of the mesentery and around 20 cm of bluish black, foul-smelling, infarcted and necrosed bowel.


CONCLUSIONS
Resection of the infarcted bowel was done with primary end-to-end anastomosis of the remaining part. The patient made an uneventful recovery and delivered a male infant vaginally at 41 weeks.
Essilfie
Papa
P
Departments of Obstetrics and Gynaecology, Doncaster Royal Infirmary, Doncaster, Northern Ireland.
Hussain
Munawar
M
Stokes
Ian M
IM
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D005260:Female; D006801:Humans; D007238:Infarction / Q000209:etiology / Q000601:surgery; D045822:Intestinal Volvulus / Q000150:complications* / Q000209:etiology* / Q000601:surgery; D007579:Jejunal Diseases / Q000209:etiology* / Q000601:surgery; D007583:Jejunum / Q000473:pathology; D010535:Laparoscopy; D050498:Live Birth; D009336:Necrosis; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third