Pregnant patient with acute abdominal pain and previous bariatric surgery

Pregnant women who previously had bariatric surgery may develop acute abdominal pain during pregnancy. Two patients, 38-year-old twin primigravida (gestational age of 24+6 weeks) and a 26-year-old woman (gestational age of 24+0 weeks), both of whom had laparoscopic gastric bypass surgery previously,...

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Bibliographic Details
Published in:BMJ case reports 2019-08, Vol.12 (8), p.e228962
Main Authors: Leclercq, Wouter KG, Uittenbogaart, Martine, Niemarkt, Hendrik J, van Laar, Judith OEH
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Pain - etiology
Adult
Bariatric Surgery
Case reports
Diabetes
Female
Gastrointestinal surgery
Hernia, Abdominal - complications
Hernia, Abdominal - diagnosis
Hernia, Abdominal - diagnostic imaging
Hernia, Abdominal - surgery
Humans
Laparoscopy
Newborn babies
Obesity
Obstetrics
Pain
Pregnancy
Pregnancy Complications - diagnosis
Pregnancy Complications - diagnostic imaging
Pregnancy Complications - surgery
Pregnancy Trimester, Second
Pregnancy, Twin
Premature birth
Reminder of Important Clinical Lesson
Small intestine
Surgeons
Ultrasonic imaging
Vitamin deficiency
Weight control
Womens health
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Summary:Pregnant women who previously had bariatric surgery may develop acute abdominal pain during pregnancy. Two patients, 38-year-old twin primigravida (gestational age of 24+6 weeks) and a 26-year-old woman (gestational age of 24+0 weeks), both of whom had laparoscopic gastric bypass surgery previously, developed abdominal pain. The patients both had diffuse abdominal pain in combination with normal blood tests and imaging. Patient B had undergone laparoscopy at another centre after 5 weeks of gestation for internal herniation. After referral to our multidisciplinary bariatric–obstetric–neonatal (MD-BON) team, diagnostic laparoscopy was advised as internal herniation was deemed possible. In both patients, internal herniation was indeed found in Petersen’s space and jejunal mesenteric defect, which was closed using laparoscopic surgery. Both women delivered healthy offspring afterwards. The presence of an MD-BON team allows for an increased awareness of potential long-term complications associated with earlier bariatric surgery in pregnancy.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-228962