Pregnant and severe acute abdominal pain

A surgical diagnostic dilemma

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

Research output: Contribution to journalArticle

2 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 - 16 Nov 2015

Fingerprint

Intestinal Volvulus
Acute Pain
Abdominal Pain
Meckel Diverticulum
Pregnancy
Acute Abdomen
Premature Obstetric Labor
Diverticulum
Appendicitis
Abdomen
Laparotomy
Nausea
Uterus
Vomiting
Tomography
Pain
Therapeutics

Keywords

  • Diverticulum
  • Obstruction
  • Pregnancy
  • Small bowel
  • Volvulus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pregnant and severe acute abdominal pain : A surgical diagnostic dilemma. / Nik Mahmood, Nik Ritza Kosai; Amin-Tai, H.; Gendeh, H. S.; Salleh, S.; Reynu, R.; Taher, M. M.; Sutton, P. A.; Das, Srijit.

In: Clinica Terapeutica, Vol. 166, No. 3, 16.11.2015, p. 110-113.

Research output: Contribution to journalArticle

Nik Mahmood, NRK, Amin-Tai, H, Gendeh, HS, Salleh, S, Reynu, R, Taher, MM, Sutton, PA & Das, S 2015, 'Pregnant and severe acute abdominal pain: A surgical diagnostic dilemma', Clinica Terapeutica, vol. 166, no. 3, pp. 110-113. https://doi.org/10.7417/CT.2015.1839
Nik Mahmood, Nik Ritza Kosai ; Amin-Tai, H. ; Gendeh, H. S. ; Salleh, S. ; Reynu, R. ; Taher, M. M. ; Sutton, P. A. ; Das, Srijit. / Pregnant and severe acute abdominal pain : A surgical diagnostic dilemma. In: Clinica Terapeutica. 2015 ; Vol. 166, No. 3. pp. 110-113.
@article{cb6210917b7d47d6a864653b4d253b97,
title = "Pregnant and severe acute abdominal pain: A surgical diagnostic dilemma",
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.",
keywords = "Diverticulum, Obstruction, Pregnancy, Small bowel, Volvulus",
author = "{Nik Mahmood}, {Nik Ritza Kosai} and H. Amin-Tai and Gendeh, {H. S.} and S. Salleh and R. Reynu and Taher, {M. M.} and Sutton, {P. A.} and Srijit Das",
year = "2015",
month = "11",
day = "16",
doi = "10.7417/CT.2015.1839",
language = "English",
volume = "166",
pages = "110--113",
journal = "Clinica Terapeutica",
issn = "0009-9074",
publisher = "Societa Editrice Universo",
number = "3",

}

TY - JOUR

T1 - Pregnant and severe acute abdominal pain

T2 - A surgical diagnostic dilemma

AU - Nik Mahmood, Nik Ritza Kosai

AU - Amin-Tai, H.

AU - Gendeh, H. S.

AU - Salleh, S.

AU - Reynu, R.

AU - Taher, M. M.

AU - Sutton, P. A.

AU - Das, Srijit

PY - 2015/11/16

Y1 - 2015/11/16

N2 - 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.

AB - 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.

KW - Diverticulum

KW - Obstruction

KW - Pregnancy

KW - Small bowel

KW - Volvulus

UR - http://www.scopus.com/inward/record.url?scp=84947064264&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947064264&partnerID=8YFLogxK

U2 - 10.7417/CT.2015.1839

DO - 10.7417/CT.2015.1839

M3 - Article

VL - 166

SP - 110

EP - 113

JO - Clinica Terapeutica

JF - Clinica Terapeutica

SN - 0009-9074

IS - 3

ER -