Large bowel obstruction in pregnancy: a rare entity, an unusual cause.
BACKGROUND
Large bowel obstruction is a rare and difficult diagnosis in pregnancy. Common causes are caecal and sigmoid volvulus and less common pseudo-obstruction. An infrequent cause of large bowel obstruction from an adhesive band in pregnancy causing diagnostic difficulty is reported.


METHODS
Report of an unusual cause of large bowel obstruction in pregnancy.


RESULTS
Diagnostic colonoscopy confirmed large bowel obstruction at the level of sigmoid. Laparotomy revealed this to be from a single band adhesion originating from the site of previous appendicectomy. Division of the band resolved the obstruction.


CONCLUSIONS
A high index of suspicion is necessary for the diagnosis of large bowel obstruction in pregnancy especially in women with previous history of abdominal or pelvic surgery. Colonoscopy is helpful avoiding radiation to foetus and mother. Prompt surgical intervention reduces risks and maximises chances for a favourable outcome for both mother and child.
Mirza
Muhammad S
MS
Department of General Surgery, Derby City General Hospital, Uttoxeter Road, Derby, UK. msmirza@doctors.org.uk
Mulla
Mubashir
M
Hall
Richard I
RI
D015746:Abdominal Pain; D000328:Adult; D001062:Appendectomy / Q000009:adverse effects; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D005865:Gestational Age; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000601:surgery; D012810:Sigmoid Diseases / Q000209:etiology / Q000601:surgery; D000267:Tissue Adhesions / Q000150:complications; D014839:Vomiting