Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2025; 13(29): 109406
Published online Oct 16, 2025. doi: 10.12998/wjcc.v13.i29.109406
Fatal small bowel perforation complicating intestinal obstruction in pregnancy: A case report
Felix Pius Omullo, Odenyo Stella Anyango, Benard Munyao Mutua, Mike Onyango Odoyo, Harambee Moses Gogo, Victor Omondi Obung'a
Felix Pius Omullo, Department of Surgery, Murang’a County Referral Hospital, Murang'a 10200, Central, Kenya
Odenyo Stella Anyango, Benard Munyao Mutua, Department of Obstetrics and Gynecology, Makueni County Referral Hospital, Makueni 95-90300, Kenya
Mike Onyango Odoyo, Clinic, Kenya Medical Research Institute, Kisumu 614-40100, Kenya
Harambee Moses Gogo, School of Medicine, University of Nairobi, Nairobi 30197-00100, Kenya
Victor Omondi Obung'a, School of Medicine, Kenyatta University, Nairobi 43844-00100, Kenya
Author contributions: Omullo FP conceptualized the study, drafted the manuscript and coordinated revisions; Anyango OS and Mutua BM directly managed the patient’s surgical and obstetric care, performed the emergency laparotomy and provided intraoperative decision-making; Odoyo MO interpreted imaging findings and refined case presentation; Gogo HM prepared figures and formatted references; Obung’a VO supervised manuscript development and approved the final version.
Informed consent statement: Written informed consent was obtained from the patient’s next-of-kin to publish this case report. All management followed standard hospital protocol and ethical guidelines for patient care.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Felix Pius Omullo, MD, Researcher, Department of Surgery, Murang’a County Referral Hospital, Kiharu Township, Murang'a 10200, Kenya. piuskirasia@gmail.com
Received: May 16, 2025
Revised: June 24, 2025
Accepted: August 8, 2025
Published online: October 16, 2025
Processing time: 110 Days and 21.9 Hours
Core Tip

Core Tip: Intestinal obstruction in pregnancy, though rare, carries catastrophic risks - including a 20%-30% maternal mortality rate when complicated by perforation. We present a tragic case of small bowel obstruction in a 25-year-old woman at 28 weeks of gestation, leading to perforation, sepsis, fetal loss, and maternal death. This case underscores three critical lessons: (1) Abdominal pain in pregnancy with a surgical history demands immediate imaging (low-dose computed tomography/Magnetic resonance imaging if ultrasound equivocal); (2) Multidisciplinary teams must collaborate for time-sensitive interventions; and (3) Delayed surgery beyond 24 hours of symptoms increases mortality risk.