Postpartum acute abdomen and its diagnostic challenges.

This is the case of a 25-year-old primigravida with gradual onset abdominal pain and vomiting, 1 day postvaginal delivery. After three hospital admissions over the following 3 weeks, a diagnosis of small bowel obstruction secondary to adhesions was made; the patient had undergone a previous appendicectomy. The patient was taken to theatre for laparotomy and adhesiolysis, where the bowel was found to be viable but with two small serosal tears. Postoperative recovery was uncomplicated. This case highlights the importance of assessing abdominal pain in the puerperium in a similar manner to that done in a non-pregnant state, to avoid delay in diagnosis. 2015 BMJ Publishing Group Ltd.