TITLE:
Acute Surgical Emergencies during Pregnancy: Diagnostic and Therapeutic Challenges Illustrated by Clinical Cases and Literature Review
AUTHORS:
Astou Coly Niassy Diallo, Ibrahim Rahadat, Ibrahima Ka, Babacar Biaye, Dialtabe Ibrahima Guesse Ba, Papa Adama Dieng, Marie-Édouard Faye, Jean-Charles Moreau
KEYWORDS:
Pregnancy, Surgical Emergency, Abdominal Aortic Aneurysm, Sigmoid Volvulus, Bartholin’s Abscess, Adnexal Torsion, Maternal-Fetal Outcome
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.9,
September
12,
2025
ABSTRACT: Background: Acute surgical emergencies during pregnancy are uncommon but carry high maternal-fetal risks. The physiological changes of gestation often mask symptoms, leading to diagnostic delays and therapeutic dilemmas. Objective: To illustrate the diagnostic and therapeutic challenges of non-obstetric surgical emergencies in pregnancy through four clinical cases managed in tertiary and district-level hospitals in Senegal, and to contextualize these cases with a literature review. Cases: We describe: (1) a juxtarenal and infrarenal abdominal aortic aneurysm with impending rupture at 29 weeks, (2) a sigmoid volvulus in early pregnancy, (3) an infected Bartholin’s gland cyst at 34 weeks with risk of para-rectal extension and hemorrhage, and (4) adnexal torsion mimicking ruptured ectopic pregnancy at 12 weeks in a woman later found to carry an intrauterine pregnancy complicated by fetal adrenal neuroblastoma. Conclusion: These cases highlight the diversity and severity of surgical emergencies in pregnancy, their frequent diagnostic ambiguity, and the need for rapid, multidisciplinary management. Awareness, timely imaging, and individualized therapeutic strategies are essential to improve outcomes, especially in resource-limited settings.