Anaesthetic management of intussusception in pregnancy

Abstract

A 35-year-old woman presented with a 3-month history of amenorrhoea and a ten-day history of abdominal pain, vomiting and fever. Abdomino-pelvic ultra sonogram revealed a twin gestation of 12 weeks with acute intestinal obstruction. She had an emergency exploratory laparotomy during which an ileo-ileal intussusception was found. Reaction and anastomosis was done under a balanced general anaesthetic. Intussusception in pregnancy is a rare surgical emergency, and the anaesthetic management of these patients presents a challenge. A general anaesthetic, a rapid sequence induction, high concentration of oxygen and a suitable combination of opioids, volatile agent and muscle relaxant may be used. Anaesthetic agents have an extremely low risk of teratogenicity. Pregnant patients undergoing surgery must be approached with caution and respect, but not fear. Teamwork will win and effective communication between obstetrician, surgeon, anesthesiologist and neonatologist is obligatory. Good knowledge of the simplest and fastest anaesthetic techniques available will ensure a fruitful outcome.

Keywords: anaesthesia, intussusception, obstetric patients

Annals of African Medicine Vol. 4(4) 2005: 185–187