INTERNAL HERNIA IN PREGNANCY: A RARE CASE WITH CRITICAL INSIGHTS INTO DIAGNOSIS AND SURGICAL INTERVENTION
Main Article Content
Keywords
Hernia, Pregnancy, Diagnosis, Surgical Intervention
Abstract
This is a rare case study for a 25-year-old expectant mother, gravida 2 para 1+0, with a history of irritable bowel syndrome (IBS) and previous abdominal surgeries. The patient's condition was further complicated by an episode of loose stools, followed by an absence of bowel movements or flatus, indicating a possible intestinal obstruction. This acute presentation was a stark contrast to her usual IBS symptoms and an episode of similar abdominal pain one month prior that resolved without intervention. A recent visit to a local medical center had led to the administration of corticosteroids under the presumption of labor pains, aiming to advance fetal lung development. The common symptoms of intestinal obstruction in pregnancy include abdominal pain (98%), vomiting (82%), and constipation (30%). Abdominal tenderness and abdominal peristalsis are observed in 71% and 55% of the patients, respectively There is no agreed treatment strategy for patients presenting with SBO in pregnancy. Contemporary literature suggests that patients with confirmed adhesional obstruction may be managed conservatively in the first instance
Downloads
References
(1) Kilpatrick, C. C., & Monga, M. (2007). Approach to the Acute Abdomen in Pregnancy. Obstetrics and Gynecology Clinics of North America, 34(3), 389-402. doi:10.1016/j.ogc.2007.06.002 (2) Daimon, A., Terai, Y., Nagayasu, Y., Okamoto, A., Sano, T., Suzuki, Y., . . . Ohmichi, M. (2016). A Case of Intestinal Obstruction in Pregnancy Diagnosed by MRI and Treated by Intravenous Hyperalimentation. Case Reports in Obstetrics and Gynecology, 2016, 1-4. doi:10.1155/2016/8704035 [3,18] Kalu, E., Sherriff, E., Alsibai, M. A., & Haidar, M. (2006). Gestational intestinal obstruction: A case report and review of literature. Archives of Gynecology and Obstetrics, 274(1), 60-62. doi:10.1007/s00404-005-0097-8 [4,20] Mckenna, D. A., Meehan, C. P., Alhajeri, A. N., Regan, M. C., & Okeeffe, D. P. (2007). The use of MRI to demonstrate small bowel obstruction during pregnancy. The British Journal of Radiology, 80(949). doi:10.1259/bjr/21300878 (5) Watanabe, S., Otsubo, Y., Shinagawa, T., & Araki, T. (2000). Small Bowel Obstruction In Early Pregnancy Treated By Jejunotomy And Total Parenteral Nutrition. Obstetrics & Gynecology, 96(Supplement), 812-813. doi:10.1097/00006250-200011001-00005 (6,16) Perdue, P. W., Johnson, H. W., & Stafford, P. W. (1992). Intestinal obstruction complicating pregnancy. The American Journal of Surgery, 164(4), 384-388. doi:10.1016/s0002-9610(05)80910-9 (7,13) Vannevel, V., Jans, G., Bialecka, M., Lannoo, M., Devlieger, R., & Mieghem, T. V. (2016). Internal Herniation in Pregnancy After Gastric Bypass. Obstetrics & Gynecology, 127(6), 1013-1020. doi:10.1097/aog.0000000000001429 (8,9,10) Martin, L. C., Merkle, E. M., & Thompson, W. M. (2006). Review of Internal Hernias: Radiographic and Clinical Findings. American Journal of Roentgenology, 186(3), 703-717. doi:10.2214/ajr.05.0644 (11) Baker, M. T., & Kothari, S. N. (2005). Successful surgical treatment of a pregnancy-induced Petersen’s hernia after laparoscopic gastric bypass. Surgery for Obesity and Related Diseases, 1(5), 506-508. doi:10.1016/j.soard.2005.07.008 (12) Leal-González, R., Garza-Ramos, R. D., Guajardo-Pérez, H., Ayala-Aguilera, F., & Rumbaut, R. (2013). Internal hernias in pregnant women with history of gastric bypass surgery: Case series and review of literature. International Journal of Surgery Case Reports, 4(1), 44-47. doi:10.1016/j.ijscr.2012.10.006 (14) Zachariah, S. K., & Fenn, M. G. (2014). Acute intestinal obstruction complicating pregnancy: Diagnosis and surgical management. Case Reports, 2014(Mar06 1). doi:10.1136/bcr-2013-203235 (15) Joyeux, E., Gobenceaux, A., Hoyek, T., Dellinger, P., & Sagot, P. (2016). Intestinal malrotation complicated by an occlusive syndrome involving internal hernia in a pregnant woman. Journal of Surgical Case Reports, 2016(7). doi:10.1093/jscr/rjw113 (17) Beddy, P., Keogan, M. T., Sala, E., & Griffin, N. (2010). Magnetic Resonance Imaging for the Evaluation of Acute Abdominal Pain in Pregnancy. Seminars in Ultrasound, CT and MRI, 31(5), 433-441. doi:10.1053/j.sult.2010.08.003 (19) Guilbaud, T., Bouayed, A., & Ouaissi, M. (2016). Emergency reversal of gastric bypass for missed diagnosis of internal hernia and bowel ischemia in a pregnant woman. Surgery for Obesity and Related Diseases, 12(8). doi:10.1016/j.soard.2016.08.022 (21) Sivanesaratnam, V. (2000). The acute abdomen and the obstetrician. Best Practice & Research Clinical Obstetrics & Gynaecology, 14(1), 89-102. doi:10.1053/beog.1999.0065 (22) Yumi, H. (2008). Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy. Surgical Endoscopy, 22(4), 849-861. doi:10.1007/s00464-008-9758-6 (23) Al-Fozan, H., & Tulandi, T. (2002). Safety and risks of laparoscopy in pregnancy. Current Opinion in Obstetrics and Gynecology, 14(4), 375-379. doi:10.1097/00001703-200208000-00003 (24) Torres-Villalobos, G. M., Kellogg, T. A., Leslie, D. B., Antanavicius, G., Andrade, R. S., Slusarek, B., . . . Ikramuddin, S. (2008). Small Bowel Obstruction and Internal Hernias during Pregnancy after Gastric Bypass Surgery. Obesity Surgery, 19(7), 944-950. doi:10.1007/s11695-008-9681-x [25] Webster, P., Bailey, M., Wilson, J., & Burke, D. (2015). Small bowel obstruction in pregnancy is a complex surgical problem with a high risk of fetal loss. The Annals of The Royal College of Surgeons of England, 97(5), 339-344. doi:10.1308/003588415x14181254789844
Article Sidebar
Article Details
Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.