Mechanical ileus in a pregnant woman at term pregnancy accompanied by labor pains

Abstract

Intestinal obstruction in pregnancy is a rare, but serious complication of pregnancy with significant maternal and fetal mortality. We herein report a case of intestinal strangulation in a pregnant woman with a history of pelvic surgery due to an ectopic pregnancy. Epigastric pain occurred at term pregnancy with concomitant onset of labor pains. The epigastric pain disappeared transiently, and she gave a birth to a healthy child. However, the pain appeared again after the vaginal delivery. She immediately underwent ileo-ileostomy with a diagnosis of mechanical ileus, and the postoperative course was uneventful. Mechanical ileus should be considered when examining epigastric pain in a pregnant woman with a history of abdominal or pelvic surgery even after the onset of labor pains.

Did ileal knotting trigger labor or did labor cause ileal knotting? Report of a case

“…Kuwahata et al suggested that the rapid shrinking of the uterus after delivery and sudden changes in the posi- tion of the abdominal organs might induce ileal knotting. 7 The fact that our patient had no surgical history and was referred with epigastric pain at term probably masked the clinical picture of ileal knotting. Thus, it was considered as part of the process of labor, which may have triggered labor, followed by delivery.…”

“…Mechanical bowel obstruction often occurs late in pregnancy, although it has been reported in puerperium. 7 Our patient's symptoms of MBO started at term of the gestation period, then disappeared transiently after delivery and appeared again at puerperium. We could not establish whether ileal knotting triggered labor or labor triggered ileal knotting and the ensuing events.…”

“…In preterm pregnancies without fetal nonreassuring status, childbirth may be postponed until term. 7 …”

“…Unfortunately, many of these fi ndings are also seen in a normal term pregnancy, when the abdomen is distended by the enlarged uterus, making the pregnant women prone to constipation. 7 We reported a case of ileal volvulus strangulation caused by ileal knotting, which we treated by resection because of gangrenous development. Diagnosing MBO in a pregnant woman is very diffi cult, especially when labor pains have started.…”

Small Bowel Ischemia due to Jejunum Volvulus in Pregnancy: A Case Report

“…Other causes include intussusception, hernia, and cancer [1]. Furthermore, the mortality rate of midgut volvulus in pregnancy is significantly higher (3–15%) with respect to the general population [1–3]. …”