title: Twin pregnancy complicated with bowel strangulation.
abstract: A 31-year-old primigravida at 35 weeks of gestation with twins who had no prior abdominal surgical history presented with worsening nausea, vomiting and abdominal pain. Initial screening ruled out obstetrical causes that may threaten the pregnancy. Twelve hours after the onset of symptoms, a transabdominal ultrasound revealed abdominal free fluid. A CT scan confirmed strangulated ileus involving the small bowels. Owing to non-reassuring fetal status in one of the twins, an emergency caesarean section and subsequent laparotomy were performed. The first twin presenting with fetal distress had to be resuscitated postdelivery but recovered uneventfully and met all developmental milestones by 3 months of age. The mother had a strangulated small bowel that had to be resected. She had an uncomplicated postsurgical course and gained full bowel function prior to discharge from the hospital.
authors.affiliation: International Goodwill Hospital, Yokohama, Japan.
authors.forename: Tze Fang
authors.initials: TF
authors.lastname: Wong
authors.affiliation: Department of General Surgery, Keio University, Tokyo, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Imai
authors.affiliation: Department of General Surgery, International Goodwill Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Tomita
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002585:Cesarean Section; D004200:Diseases in Twins / Q000209:etiology* / Q000601:surgery; D005260:Female; D005316:Fetal Distress / Q000209:etiology* / Q000601:surgery; D006801:Humans; D045823:Ileus / Q000150:complications* / Q000473:pathology / Q000601:surgery; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000150:complications* / Q000601:surgery; D009325:Nausea / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D059285:Pregnancy, Twin; D014839:Vomiting / Q000209:etiology