Acute intestinal obstruction in pregnancy after previous gastric bypass: A case report

Abstract

Background: Intestinal obstruction is an extremely rare condition among pregnant women, but it can be life-threatening for both mother and fetus. Case presentation: A woman in her late twenties with no history of previous pregnancies was admitted to hospital due to regular preterm contractions and cervical shortening. Seven days after her admission, while the contractions had stopped and cervical length was stable, she complained of acute abdominal pain. Bowel obstruction was suspected due to the patient's history of gastric bypass 5 years earlier for weight loss. Computed tomography was not performed due to risk of fetal irradiation. Conservative management was attempted, but the patient stopped passing flatus and started vomiting. The fetus was delivered by emergency exploratory laparotomy, during which small bowel obstruction due to adhesions was identified and resolved. Conclusion: Although uncommon during pregnancy, small bowel obstruction is far more common in women who have had previous abdominal operations, especially involving the stomach. Obstetricians must maintain a high level of suspicion since this condition can be life-threatening for both the mother and the fetus.

Keywords

• Intestinal obstruction
• Gastric bypass
• Adhesions
• Obstetric emergency
• Non-obstetric surgery during pregnancy