Acute intestinal obstruction during pregnancy

Abstract

Sub acute bowel obstruction is a rare complication during pregnancy. The condition is associated with significant maternal and fetal mortality. The delay in diagnosis is due to non specific symptoms and disinclination towards carrying out radiologic investigations in pregnancy. We are presenting the case of a 31 year old lady who presented in her 2nd trimester with symptoms suggestive of intestinal obstruction and a past history of abdominal surgery. Ultrasound abdomen showed multiple dilated small bowel loops, as cites and a single live fetus. X-ray abdomen and CECT were not done in order to prevent fetal exposure. A diagnosis of acute adhesive obstruction was made and exploratory laparo to my was done, which revealed extensive adhesions. Adhesiolysis was done. Her post-operative recovery was uneventful. This case highlights the fact that as Intestinal obstruction in pregnancy is a rare event, clinical suspicion is critical and should be increased in a patient with an abdominal scar. As the incidence of surgical procedures is increasing, it is likely to be seen more frequently. Once the diagnosis is made, the recommended treatment is surgery regardless of gestational age. Every effort should be made to avoid delay in treatment.