Pregnant and severe acute abdominal pain: A surgical diagnostic dilemma

Nik Ritza Kosai*, H. Amin-Tai, H. S. Gendeh, S. Salleh, R. Reynu, M. M. Taher, P. A. Sutton, S. Das

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Acute abdominal pain in pregnancy remains a surgical conundrum. A 25-year-old primigravid at 29 weeks gestation presented with a two-week history of epigastric pain, nausea and vomiting. She had a distended abdomen consistent with a full term gravid uterus; tender at the epigastric and right hypochondrium suggestive of small bowel obstruction or acute appendicitis. Abdominal ultrasound was inconclusive but abdominal Computed Tomography (CT) suggested small bowel volvulus. An exploratory laparotomy revealed a segmental jejunal volvulus and small bowel diverticulum contributing to the volvulus. A short segmental bowel resection was performed. Histopathology confirmed a Meckel's Diverticulum. The patient recovered well but underwent premature labour 10 days later. Small bowel obstruction secondary to Meckel's diverticulum is rare in pregnancy. In an acute gestational abdomen, clinical examination is key. Radiological imaging may be helpful, whilst surgical intervention is confirmatory and therapeutic in the event of an obstructive volvulus.

Original languageEnglish
Pages (from-to)110-113
Number of pages4
JournalClinica Terapeutica
Volume166
Issue number3
DOIs
Publication statusPublished - Nov 16 2015
Externally publishedYes

Keywords

  • Diverticulum
  • Obstruction
  • Pregnancy
  • Small bowel
  • Volvulus

ASJC Scopus subject areas

  • Medicine(all)

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