Postoperative Mechanical Bowel Obstruction Secondary to Jackson-Pratt (JP) Drain Placement in a Patient With Perforated Appendicitis

Postoperative mechanical bowel obstruction is an infrequent but significant complication following abdominal surgeries. The use of Jackson-Pratt (JP) drains (Cardinal Health, 7000 Cardinal Place, Dublin, Ohio, 43017), while effective in the prevention of fluid collections, may contribute to intestinal obstruction in rare cases. We present the case of a 50-year-old female patient with perforated appendicitis who underwent a robotic appendectomy with intraoperative JP drain placement. Her recovery gradually became complicated by progressive abdominal distention, bilious emesis, and elevated nasogastric tube output. Despite initially unremarkable postoperative radiographs, CT imaging on postoperative day 5 revealed a small bowel obstruction with a transition point near the JP drain. Exploratory laparotomy confirmed bowel entrapment around the drain, with resolution upon drain removal and adhesion lysis, and subsequent full recovery postoperatively. This case highlights the potential for JP drains to induce mechanical bowel obstruction, underscoring the importance of careful drain placement, postoperative monitoring for obstructive symptoms, and maintaining a high index of suspicion for drain-related complications in patients with delayed postoperative recovery. As clinically appropriate, alternative drain management strategies should be considered for reducing the risk of obstruction.