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We describe a case of progressive, subacute SBO in a 46-year-old woman with dichorionic diamniotic twins and a history of caesarean section. The case culminated in bowel perforation, emergency laparotomy, and preterm delivery. This case highlights the need for early recognition, appropriate imaging, and multidisciplinary management to minimize maternal and foetal morbidity.<\/jats:p>","DOI":"10.1093\/jscr\/rjag281","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:36:50Z","timestamp":1778153810000},"source":"Crossref","is-referenced-by-count":1,"title":["Subacute small bowel obstruction in a twin pregnancy: a diagnostic and management challenge"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9516-919X","authenticated-orcid":false,"given":"Katherine Gar Yen","family":"Lau","sequence":"first","affiliation":[{"name":"St. Mary's Hospital, Praed Street, Imperial College Healthcare NHS Trust , London W2 1NY ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina K H","family":"Yu","sequence":"additional","affiliation":[{"name":"St. Mary's Hospital, Praed Street, Imperial College Healthcare NHS Trust , London W2 1NY ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Frise","sequence":"additional","affiliation":[{"name":"St. Mary's Hospital, Praed Street, Imperial College Healthcare NHS Trust , London W2 1NY ,","place":["United Kingdom"]},{"name":"Queen Charlotte's and Chelsea Hospital, Du Cane Rd, Imperial College Healthcare NHS Trust , London W12 0HS ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"2026051113460495400_ref1","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/j.rcl.2015.06.008","article-title":"Bowel obstruction","volume":"53","author":"Gore","year":"2015","journal-title":"Radiol Clin North Am"},{"key":"2026051113460495400_ref2","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1053\/beog.1999.0065","article-title":"The acute abdomen and the obstetrician","volume":"14","author":"Sivanesaratnam","year":"2000","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2026051113460495400_ref3","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/AOG.0000000000002440","article-title":"Effect of Cesarean delivery on long-term risk of small bowel obstruction","volume":"131","author":"Abenhaim","year":"2018","journal-title":"Obstet Gynecol"},{"key":"2026051113460495400_ref4","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s13017-024-00541-y","article-title":"Can small bowel obstruction during pregnancy be treated with conservative management? 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