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Case Reports: Unusual presentation of more common disease/injury
Management of small bowel obstruction in the third trimester
  1. Mariam Ayyash1,
  2. Madison Miller1,
  3. Nicolina Smith2,
  4. Jeannette Espy1 and
  5. Sun Kwon Kim2
  1. 1Department of Women’s Health, Obstetrics and Gynecology, Henry Ford Health System, Detroit, Michigan, USA
  2. 2Department of Women’s Health, Division of Maternal Fetal Medicine, Obstetrics and Gynecology, Henry Ford Health System, Detroit, Michigan, USA
  1. Correspondence to Dr Mariam Ayyash; mariam.ayyash{at}gmail.com

Abstract

Small bowel obstruction (SBO) in pregnancy is exceedingly rare. Management of SBO in the third trimester may pose particular challenges, as clinicians must determine whether or not the delivery of the fetus is indicated. In this report, we review the case of a patient in her mid-20’s with no prior surgical history who presented with nausea and vomiting at 34 weeks of gestation and was ultimately diagnosed with an SBO. Following expectant management during the initial 4 days of inpatient admission, the patient subsequently underwent an exploratory laparotomy at 35 weeks without concurrent delivery. She was monitored for the remainder of her pregnancy with non-stress tests to evaluate fetal status and eventually underwent induction of labour at 39 weeks, resulting in a successful vaginal delivery. Herein, we review the challenges related to the diagnosis and management of SBO in pregnancy, as well as the maternal–fetal outcomes in the setting of SBO in the third trimester.

  • Pregnancy
  • General surgery

https://doi.org/10.1136/bcr-2023-255843

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: MA, MM, NS, JE and SKK. All authors listed gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.