Abstract
Bowel obstruction in pregnancy is a high risk situation for both the mother and baby. We present a case of a 30-week-pregnant woman who presented with abdominal pain and vomiting and was diagnosed with adhesive small bowel obstruction (SBO). Oral contrast media was successfully used as a treatment. The patient was discharged home and 10 weeks later delivered a healthy baby girl. We were unable to find any cases in the literature describing oral contrast media to treat adhesive SBO in pregnancy. From our experience and research, we consider oral contrast media as a method of treating adhesive SBO in pregnancy under the proviso that there are no signs that indicate urgent surgical intervention.
INTRODUCTION
Small bowel obstruction (SBO) in pregnancy is a high risk situation for both mother and baby with maternal mortality ranging from 2 to 4% and fetal/neonatal loss from 13 to 17%. Preterm delivery occurs in ∼45% of the cases. Adhesions were the most common pathology in 30–50% followed by internal hernias and volvulus [1, 2].
DISCUSSION
A PubMed, MEDLINE and Google Scholar search of ‘small bowel obstruction’ and ‘pregnancy’ and ‘Gastrografin’ or ‘oral contrast media’ returned one result.
Bower et al. [3] looked at SBO overall, with a section specific to pregnancy. It stated that safety analyses have not been completed on gastrointestinal contrast in pregnancy.
