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Twin pregnancy complicated with bowel strangulation.
Tze Fang Wong1, Shunichi Imai2, Masato Tomita3
1International Goodwill Hospital, Yokohama, Japan.
BMJ Case Reports
|September 9, 2014
Summary
A pregnant woman with twins experienced severe abdominal pain due to strangulated small bowel obstruction. Emergency surgery was performed, saving both mother and babies, highlighting the importance of prompt diagnosis in high-risk pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Gastroenterology
- Surgical Case Report
Background:
- Strangulated small bowel obstruction is a rare but serious surgical emergency.
- Pregnancy can alter the typical presentation of abdominal pathologies, complicating diagnosis.
- Timely intervention is critical for maternal and fetal outcomes in such cases.
Observation:
- A 31-year-old primigravida at 35 weeks gestation presented with acute nausea, vomiting, and abdominal pain.
- Initial obstetric evaluation ruled out pregnancy-related complications.
- Ultrasound revealed free fluid, and CT scan confirmed strangulated small bowel obstruction.
Findings:
- Emergency Cesarean section was performed due to non-reassuring fetal status in one twin.
- Laparotomy revealed strangulated small bowel requiring resection.
- Both twins and the mother recovered well postoperatively.
Implications:
- This case underscores the need for a high index of suspicion for surgical emergencies in pregnant patients.
- Multidisciplinary management involving obstetrics and surgery is crucial for optimal outcomes.
- Prompt diagnosis and surgical intervention can lead to successful maternal and fetal salvage.
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