title: Advanced colorectal cancer resulting in acute bowel obstruction during pregnancy; a case report.
abstract: BACKGROUND
  Abdominal pain is frequently found in the pregnant population; however life-threatening pathology such as colorectal cancer does occur rarely. As such, intestinal obstructions are usually attributed to pregnancy-related issues. We present the case of a young woman with an acute bowel obstruction caused by advanced colorectal carcinoma.
  
  
  METHODS
  A 34-year old pregnant woman was referred to our emergency department with complaints of severe upper abdominal pain. Initial investigations did not show abdominal pathology and conservative treatment for obstipation was commenced. However, complaints persisted and a near blowout of the colon was diagnosed, prompting a caesarean section and diagnostic laparotomy. An obstructing tumour was found and a left-sided hemi-colectomy was performed. Unfortunately, skeletal, lymphatic and additional hepatogenic metastasis were discovered during chemotherapy and treatment was discontinued.
  
  
  CONCLUSIONS
  The mainstay of abdominal complaints during pregnancy can be attributed to normal physiological alterations associated with gravidity. Nonetheless serious pathology should be considered, especially when conservative treatment fails. On this note, diagnostic imaging during pregnancy should be used promptly upon suspicion of serious abdominal pathology.
authors.affiliation: Department of Surgery, Spaarne Gasthuis, P.O. Box 417, 2000 AK, Haarlem, The Netherlands; Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Rikkert R
authors.initials: RR
authors.lastname: Ossendorp
authors.affiliation: Department of Surgery, Spaarne Gasthuis, P.O. Box 417, 2000 AK, Haarlem, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Silvis
authors.affiliation: Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Gerben J
authors.initials: GJ
authors.lastname: van der Bij
keywords: Abdominal pain; Colorectal neoplasms; Diagnostic imaging; Pregnancy; Surgery