Ducarme Guillaume, Lidove Olivier, Leduey Alexandre, Geffroy Arnaud, Panis Yves, Luton Dominique, Castier Yves
Departments of Obstetrics, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Université Paris, Clichy, France.
Obstet Gynecol. 2008 Feb;111(2 Pt 2):535-7. doi: 10.1097/01.AOG.0000284629.65095.3a.
Several causes of severe and acute postpartum abdominal pain (pelvic infection, complications of pelvic thromboembolism, arterial ischemia) require early diagnosis and prompt therapy.
Eight days after a normal vaginal delivery, a 38-year-old woman presented with severe acute abdominal pain that had been going on for 3 days. Abdominal computed tomography showed a superior mesenteric artery thrombosis with suggested ileal wall ischemia. An emergency thrombectomy associated with ileal resection and ileostomy were performed. No identifiable source of embolism, hemostatic disorder, systemic vasculitis, or systemic disease associated with thrombosis was found.
Even after a vaginal delivery, the postpartum period is associated with an increased risk of complications of thromboembolism. In the case of acute abdominal pain, abdominal contrast-enhanced computed tomography may be necessary to exclude mesenteric arterial ischemia.
严重急性产后腹痛的几种病因（盆腔感染、盆腔血栓栓塞并发症、动脉缺血）需要早期诊断和及时治疗。
一名38岁女性在正常阴道分娩8天后出现持续3天的严重急性腹痛。腹部计算机断层扫描显示肠系膜上动脉血栓形成，提示回肠壁缺血。进行了紧急血栓切除术，并联合回肠切除术和回肠造口术。未发现可识别的栓塞源、止血障碍、系统性血管炎或与血栓形成相关的全身性疾病。
即使是阴道分娩后，产后期血栓栓塞并发症的风险也会增加。对于急性腹痛，可能需要进行腹部增强计算机断层扫描以排除肠系膜动脉缺血。
