An Incarcerated Hernia Complicated by Intestnal Obstructon during Pregnancy - A Case Report Aliou Diouf 1,2* , Abdourahmane Ndong 1 , Ousmane Thiam 1 , Mamour Guèye 2 , Mame Diarra Guèye 2 , Djibril Bahaid Sow 1 , Cherif Tourad Sarr 1 and Ibrahima Konaté 3 1 Regional Hospital Center of Saint-Louis, BP 401, Saint-Louis, Senegal 2 Gynecological and Obstetric Clinic, EPS Aristde Le Dantec, BP, Senegal 3 Gaston Berger University, BP 234, Saint-Louis, Senegal * Corresponding author: Dr. Aliou Diouf, Gynecological and Obstetric Clinic, EPS Aristde Le Dantec Regional Hospital Center of Saint-Louis, Senegal, Tel:+ 221776412302, E-mail: alioudiouf69@yahoo.com Received date: May 11, 2020; Accepted date: June 04, 2020; Published date: June 11, 2020 Citaton: Diouf A, Ndong A, Thiam O, Gueye M, Gueye MD, et al. (2020) An Incarcerated Hernia Complicated by Intestnal Obstructon during Pregnancy - A Case Report. Med Case Rep Vol.6 No.2:141. Abstract Context: Hernias generally coexist with pregnancy; however, an incarcerated hernia with intestnal obstructon is rare at an advanced stage of gestaton and requires urgent interventon. Case report: A multparous woman with a known large incisal hernia presented at 18 weeks and 5 days of gestatonal age and prior to laparotomy 10 years ago The patent was diagnosed with intestnal obstructon secondary to an incarcerated hernia with complete occlusive syndrome caused by the cessaton of materials and gases, nausea, vomitng and severe abdominal pain. She underwent betamimetcs tocolysis throughout the clinical and therapeutc process, before during and afer surgery. An obstetric ultrasound done 72 hours afer surgery confrms the vitality of the fetus. Conclusion: Intestnal incarceraton by incisional hernia can occur during pregnancy and lead to favorable maternal and neonatal results. Keywords: Small bowel obstructon; Incarcerated bowel; Incarcerated hernia; Pregnancy Introducton Typically, hernias do not present as an acute problem to the obstetrician during pregnancy because the physiologic changes of pregnancy and the gravid uterus are protectve against hernia complicatons [1,2]. Hernias are ofen asymptomatc; however, they can become incarcerated, or irreducible, necessitatng urgent surgical correcton. An incarcerated hernia with small bowel obstructon during pregnancy is a rare challenge for the obstetrical and general surgery teams because the need for urgent surgical exploraton to prevent bowel ischemia may require concurrent delivery. A strangulated hernia has high mortality for both the patent and her fetus [3,4]. This clinical case that we report required a frank and coordinated collaboraton between the gynecological surgery team and that of general visceral surgery, which allowed us to skip this patent and her pregnancy. Case Report A 31-year-old woman gravida 3-para 2 with a history of laparotomy 10 years ago not documented carrying an 18 week and 5 day pregnancy and received in an occlusive syndrome table intense abdominal pain, nausea and postprandial vomitng. The examinaton of the patent was signifcant for a slightly tender irreducible mass 8 pounds 8 cm lower than her navel; Murphy's sign was missing. The uterus was enlarged but no sensitvity was objectfed. There was no skin change on the mass. The patent was afebrile with a white blood cell number of 12.6 and normal electrolytes. The hemogobin level was 12 g/dL. The monitoring of the fetal heart rate was reassuring. There was no uterine contracton or sign for a threat of aborton. The patent had been examined by the general surgery team, which had concluded that there was a surgical emergency in front of a ventral hernia probably secondary to the mid-umbilical laparotomy 10 years ago. The patent is unable to provide more informaton regarding this surgical procedure. The patent postponed the recommended surgical repair and then became pregnant. The patent was asymptomatc before and during pregnancy, before her current presentaton. Her obstetric history reveals two vaginal deliveries at term. She never had a Cesarean. The patent was admited for management of her bowel obstructon and incarcerated hernia. The fetal tests were reassuring. A multdisciplinary meetng with obstetricians and general surgeons weighed the risks and benefts of immediate Case Report iMedPub Journals www.imedpub.com DOI: 10.36648/2471-8041.6.2.141 Medical Case Reports ISSN 2471-8041 Vol.6 No.2:141 2020 © Copyright iMedPub | This article is available from: 10.36648/2471-8041.6.2.141 1