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Acute intestinal obstruction complicating pregnancy: diagnosis and surgical management

Intestinal obstruction during pregnancy is an uncommon and serious non-obstetric surgical condition which may be associated with significant maternal and fetal mortality. Surgeons who are called upon to manage these patients are often confronted with a diagnostic and therapeutic challenge due to the rarity of the condition, overlapping symptomatology, concerns over radiological evaluation and risks involved with surgery and anaesthesia. We report a 31-year-old woman who presented with acute intestinal obstruction during the third trimester of pregnancy. Plain abdominal X-ray was diagnostic of intestinal obstruction. Conservative treatment was unsuccessful. On laparotomy, the small bowel was found to have twisted at three different sites due to adhesive bands from previous abdominal surgeries. Division of these bands released the obstruction. The child was delivered through a concomitant caesarean section. A high index of clinical suspicion coupled with timely surgical intervention increases the chances for a favourable outcome in these situations.