Korean J Obstet Gynecol.  2010 Jun;53(6):525-530. 10.5468/kjog.2010.53.6.525.

A case of small bowel obstruction with elevated aspartate transaminase/alanine transaminase (AST/ALT) in the third trimester of pregnancy

• Park JH
• Yoon SH
• Jeon DS
• Yang HS
• Lee CH
• Park HS
• Min EG

• KMID: 2273893
• DOI: http://doi.org/10.5468/kjog.2010.53.6.525

Abstract

The intestinal obstruction during pregnancy is rare but early diagnosis and treatment is essential. This disease can be diagnosed very late because the presenting symptoms such as nausea, vomiting and abdominal pain are often seen in normal pregnancies and most pregnant women avoid radiologic examinations. Moreover, this disease can be accompanied by high aspartate transaminase/alanine transaminase (AST/ALT) which can be also found in acute fatty liver of pregnancy or preeclampsia, and it makes diagnosis to be much delayed. If the diagnosis were delayed much, maternal and perinatal mortality would be increased highly. Therefore, the previous record of abdominal surgery or above mentioned symptom should be considered as the intestinal obstruction, and simple abdominal x-ray for early diagnosis and prompt operation step are critical. We present a case of small bowel obstruction accompanied with high AST/ALT during pregnancy which had the history of previous cesarean section with a brief review of the literature.

Keyword

Intestinal obstruction; Pregnancy; Fatty liver

MeSH Terms

Abdominal Pain
Aspartic Acid
Cesarean Section
Early Diagnosis
Fatty Liver
Female
Humans
Intestinal Obstruction
Nausea
Perinatal Mortality
Pre-Eclampsia
Pregnancy
Pregnancy Complications
Pregnancy Trimester, Third
Pregnant Women
Vomiting
Aspartic Acid
Fatty Liver
Pregnancy Complications

Reference

1. Perdue PW, Johnson HW Jr, Stafford PW. Intestinal obstruction complicating pregnancy. Am J Surg. 1992. 164:384–388.

2. Connolly MM, Unti JA, Nora PF. Bowel obstruction in pregnancy. Surg Clin North Am. 1995. 75:101–113.

3. Beck WW Jr. Intestinal obstruction in pregnancy. Obstet Gynecol. 1974. 43:374–378.

4. Sharp HT. The acute abdomen during pregnancy. Clin Obstet Gynecol. 2002. 45:405–413.

5. Ballantyne GH, Brandner MD, Beart RW Jr, Ilstrup DM. Volvulus of the colon. Incidence and mortality. Ann Surg. 1985. 202:83–92.

6. Simpson , Smets M, Malvaux V, Anaf V, Donnez J. Laparoscopic myolysis with the Nd:YAG laser. J Gynecol Surg. 1993. 9:95–99.

15. Jung H, Lim JS, Chon HJ. Comparison of bipolar coagulator and ultrasonic surgical system on laparoscopy-assisted vaginal hysterectomy. J Gynecol Surg. 2005. 21:73–79.

16. Goldfarb HA. Nd:YAG laser laparoscopic coagulation of symptomatic myomas. J Reprod Med. 1992. 37:636–638.

17. Lueken RP, Gallioat A. Endoscopic surgery in gynecology. 1993. Berlin: Demeter Verlag GmBH Press;71–88.

18. Wood C, Maher P, Hill D. Myoma reduction by electrocautery. Gynecol Endosc. 1994. 3:163–165.

19. Phillips DR, Goldfarb HA. Laparoscopic leiomyoma coagulation-myolysis. Surg Technol Int. 1997. 6:187–191.

20. Lee BB. Radio frequency ablation of uterine myomas: Two-year-follow-up. AAGL 33rd Annual Meetings. 2004 Nov 10-13; San Francisco, CA, USA.

21. Kim SA, Jung H. The 1-year follow-up results of radiofrequency myolysis on uterine myomas. Korean J Obstet Gynecol. 2008. 51:1137–1141.