Incisional hernia with bowel incarceration and obstruction at 34 weeks gestational age.
BACKGROUND
Hernias commonly coexist with pregnancy; however, an incarcerated hernia with bowel obstruction is rare at advanced gestation and requires urgent intervention.


METHODS
A multiparous woman with a known large incisional hernia presented at 33 weeks and 5 days gestational age with acute-onset, upper abdominal pain and nausea. The patient was diagnosed with small bowel obstruction secondary to an incarcerated hernia. She was managed with serial abdominal exams until her repeat cesarean section and simultaneous hernia repair were performed 24 h after admission and betamethasone administration. The patient and infant did well postoperatively.


CONCLUSIONS
Bowel incarceration through an incisional hernia can occur during pregnancy and result in favorable maternal and neonatal outcomes with simultaneous delivery and surgical repair.
Obstetrics and Gynecology Department, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. bcyoung@bidmc.harvard.edu
Brett C
BC
Young
Dana
D
Fugelso
Tamara
T
Takoudes
D005260:Female; D005865:Gestational Age; D046449:Hernia, Abdominal / Q000150:complications*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*