Background: Colonic intussusception during pregnancy is an extremely rare case that may have occurred due to various factors like colon cancer, fibroma, colonic leiomyoma and lipoma. It requires a multidisciplinary approach to managing parturient presented with those cases, especially during labour. Colonic intussusception has no specific symptoms to differentiate it from labour induced pain and is also difficult to image during this period. This is a case report of colonic intussusception managed with spinal anesthesia combined with controlled general anesthesia for both maternal and foetal outcomes. Case presentation: A 32-year-old gravida IV para III, 38-week gestational age female patients with a history of severe abdominal pain, nausea, and vomiting presented to our institution. She has had pushing-down pain for six hours’ duration, sweating, abdominal cramping, and fever for 2 days’ duration. Immediately after she entered the gynecology department, she was diagnosed with obstructed labour and prepared for an emergency caesarean section. After the cesarean section was conducted, the baby was delivered, and uterine contractility was checked. A palpable tubular mass on the mesenteric side of the ischemic colon was appeared. The ischemic colon was packed with warm water until peristalsis regains. The abdomen was washed thoroughly, and a biopsy was taken from the mass. Conclusion: Anesthesia management for unexpected cases during pregnancy is very challenging and requires caution for both intraoperative maternal life and postoperative morbidity. There is no gold standard and safe anesthesia technique for pregnancy patients presented with a non-obstetric emergency like bowel obstruction. Therefore, risks and benefits of the technique, and the perioperative patient condition should be considered. Our case was managed with spinal anesthesia with controlled general anesthesia for both the mother and neonate with good outcomes.
Hordofa et al. (Thu,) studied this question.