Fatal small bowel perforation complicating intestinal obstruction in pregnancy: A case report

Table 1 Full hemogram findings

Parameter	Results	Result units	Reference range
WBC	3.79	× 109/L	4.0–10.0 × 109
Neutrophils	81.6	%	40–75
Lymphocytes	11.1	%	21–40
Monocytes	5.4	%	3–12
Eosinophils	1.4	%	0.5–5
Basophils	0.5	%	0.5–5
Neutrophils absolute	3.1	× 109/L	1.8–6.3
Lymphocytes absolute	0.42	× 109/L	1.1–3.2
Monocytes absolute	0.21	× 109/L	0.1–0.6
Eosinophils absolute	0.05	× 109/L	0.02–0.52.
Basophils absolute	0.01	× 109/L	0.0–6.3
RBC	4.48	× 109/L	4.7–6.1
HB	12.5	g/dL	11.2–16.0
HCT	37.5	%	37.0–47.0
MCV	83.8	fL	76.0–100.0
MCH	33.4	pg	27.0–31.0
MCHC	46.2	g/dL	32.0–36.0
RDW-CV	13.1	%	35.0–56.0
Platelets	241	× 109/L	160.0–450.0
MPV	9.5	fL	6.5–12.0
PDW	15.9	%	9.0–17.0
PCT	0.228	%	0.108–0.282

RBC: Red blood cells; HB: Hemoglobin; HCT: Hematocrit; MCV: Mean corpuscular volume; MCH: Mean corpuscular hemoglobin; MCHC: Mean corpuscular hemoglobin concentration; RDW-CV: Red cell distribution width - coefficient of variation; Platelets: Platelet count; MPV: Mean platelet volume; PDW: Platelet distribution width; PCT: Plateletcrit.

Table 2 Liver function test findings

Parameter	Results	Result units	Reference range
Albumin	18.33	g/L	35–52
ALP	0	U/L	35–104
ALT	46.2	U/L	0–40
AST	23.9	U/L	0–32
GGT	6.7	U/L	5–36
Total protein	33.4	g/L	66-87

ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: Gamma-glutamyl transferase.

Table 3 Urea, creatinine, and electrolytes findings

Parameter	Results	Result units	Reference range
Chloride	101.5	mmol/L	95–107
Creatinine	66	μmol/L	44–80
Potassium	2.86	mmol/L	3.5–5.1
Sodium	134.7	mmol/L	135-145
Urea	4.94	mmol/L	2.76-8.07

Table 4 C-reactive protein findings

Parameter	Results	Result units	Reference range
CRP	205.2	mg/L	0–10.0

CRP: C-reactive protein.

Table 5 Summary of literature reporting outcomes of intestinal obstruction in pregnancy

Ref.	Key findings	Management	Outcome
Shen et al[15], 2023	IO at 34 weeks of gestation presenting as uterine perforation	Initial conservative treatment failed. Emergency cesarean section followed by surgical repair of uterine rupture	Maternal recovery; fetal outcome not specified
Zhao et al[16], 2020	IO due to reverse rotation of the midgut at 26 weeks of gestation; rare anatomical cause	Surgical correction via laparotomy	Both mother and fetus had favorable outcomes
Daimon et al[17], 2016	IO at 20 weeks of gestation due to adhesions	Laparotomy after failure of conservative treatment	Both mother and fetus recovered well
Loukopoulos et al[18], 2022	IO at 30 weeks gestation presenting with atypical symptoms; initial misdiagnosis	Laparotomy after correct diagnosis	Successful outcomes for both mother and fetus
Current case	G2P1 woman at 28 weeks with IO due to adhesions post-laparotomy; delayed presentation. Initial ultrasound	Laparotomy after > 72 hours; found perforation and contamination. Spontaneous miscarriage, anastomotic leak	Fetal and maternal mortality

IO: Intestinal obstruction; G: Gravida; P: Para.