Presentation
26 weeks pregnant. BNO. No flatus two weeks. Persistent perfuse vomiting. Severe acidosis ? bowel obstruction.
Patient Data
Twin pregnancy is demonstrated.
No evidence of obstruction. Gas is present in the rectum. No bony lesion seen. No soft tissue abnormality detected.
Case Discussion
The patient's presenting symptoms were reviewed in consultation with the obstetric consultant. In light of patient's metabolic and biochemical profile (Na 125, HCO3- low, elevated anion gap (metabolic acidosis)) and acute rise in creatinine (0.85) suggesting renal failure, in setting of unopened bowels for 2 weeks it was decided that an acute bowel obstruction needed to be excluded. In this case, the potential for compromise of maternal health outweighed the fetal radiation exposure.
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