Acute Postoperative Intestinal Obstruction Due to Abdominal Drains: A Case Report

Abstract

Early small bowel obstruction caused by a drain in the postoperative period is a rare complication, with few cases reported in the literature. Its diagnosis is difficult, and its complications can be severe. The objective of this case report is to describe the clinical and radiological features suggestive of intestinal occlusion associated with abdominal drains and to summarize the management strategies reported in the literature for this rare complication. We report a case of acute intestinal obstruction caused by an abdominal drain after rectal surgery, documented in the oncology surgery department of the Regional Oncology Hospital of Oujda, Morocco, in 2023. Our report describes the case of a 64-year-old woman who developed acute intestinal obstruction following rectal surgery, caused by a prophylactic Jackson-Pratt-type drain. Paraclinical investigations revealed a mechanical small bowel obstruction with a sudden change in bowel caliber. Data from the literature show that intestinal obstructions caused by drains are rare but serious. Interpreting CT signs in a postoperative context is complex. Rigorous management of drain placement indications could reduce the incidence of obstructions related to these devices. Early small bowel obstruction as a complication of an abdominal drain is rare. Its clinical presentation is misleading and may be masked by seemingly normal signs after surgery, such as postoperative ileus. However, it should be considered as a differential diagnosis in cases of postoperative bowel obstruction. Once the diagnosis is made and the absence of signs of digestive compromise requiring reoperation has been confirmed, the drain should be removed.