Garnizov T, Marinov B, Dukovski A, Borisov I, Slŭncheva B
Akush Ginekol (Sofiia). 2006;45(2):57-60.
The authors present a case of a 32 year old pregnant woman who is admitted to the Obstetric clinic in the 16th gestational week with a pain in the ileoceacal region of the abdomen and vomitting. The woman has clinical signs of acute abdomen. A clinical diagnosis of acute appendicitis was suggested. During the operation under general anesthesia was found a phlegmonous inflammation of a Mekel diverticulus with perforation as well as local peritonitis and a catharal inflammation of the appendix. The appendix and the Mekel diverticle were removed during the operation. No comlications were observed during the post operative period. No fetal distress was observed during and after the operation Three months later the same patient was admitted to the obstetric clinic in the 32nd gestational week with a diagnosis Threatened premature delivery in ml VIII status post resection of a Mekel diverticle and appendectomy. The patient had pain to the right of the umbilicus and vomiting. The labor was induced and a viable premature infant was born. Two days after delivery there was again a clinical symptoms and signs of an acute abdomen due to ileus. A strangulation of the terminal ileum was found due to adhesions A Debridman and a lavage were performed No complications were observed during the postoperative period. The authors discuss the difficulties which might ensue when the diagnosis acute abdomen is made in a pregnant woman
作者报告了一例32岁孕妇的病例，该孕妇在妊娠第16周时因腹部回盲部疼痛和呕吐入住产科诊所。该名女性有急腹症的临床体征。初步临床诊断为急性阑尾炎。在全身麻醉下进行手术时，发现梅克尔憩室有蜂窝织炎伴穿孔以及局部腹膜炎，阑尾有卡他性炎症。手术中切除了阑尾和梅克尔憩室。术后未观察到并发症。手术期间及术后均未观察到胎儿窘迫。三个月后，该患者在妊娠第32周时再次入住产科诊所，诊断为梅克尔憩室和阑尾切除术后，处于第八期，有早产迹象。患者脐右侧疼痛并呕吐。引产分娩出一名存活的早产儿。产后两天，又出现了因肠梗阻导致的急腹症临床症状和体征。发现由于粘连导致回肠末端绞窄。进行了清创和灌洗。术后未观察到并发症。作者讨论了对孕妇进行急腹症诊断时可能出现的困难。
