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妊娠期大肠梗阻:一种罕见的病症,一个不寻常的病因。

Large bowel obstruction in pregnancy: a rare entity, an unusual cause.

作者信息

Mirza Muhammad S, Mulla Mubashir, Hall Richard I

机构信息

Department of General Surgery, Derby City General Hospital, Uttoxeter Road, Derby, UK.

出版信息

Arch Gynecol Obstet. 2009 Feb;279(2):177-8. doi: 10.1007/s00404-008-0656-x. Epub 2008 Apr 24.

Abstract

BACKGROUND

Large bowel obstruction is a rare and difficult diagnosis in pregnancy. Common causes are caecal and sigmoid volvulus and less common pseudo-obstruction. An infrequent cause of large bowel obstruction from an adhesive band in pregnancy causing diagnostic difficulty is reported.

METHODS

Report of an unusual cause of large bowel obstruction in pregnancy.

RESULTS

Diagnostic colonoscopy confirmed large bowel obstruction at the level of sigmoid. Laparotomy revealed this to be from a single band adhesion originating from the site of previous appendicectomy. Division of the band resolved the obstruction.

CONCLUSIONS

A high index of suspicion is necessary for the diagnosis of large bowel obstruction in pregnancy especially in women with previous history of abdominal or pelvic surgery. Colonoscopy is helpful avoiding radiation to foetus and mother. Prompt surgical intervention reduces risks and maximises chances for a favourable outcome for both mother and child.

摘要

背景

大肠梗阻在妊娠期间是一种罕见且难以诊断的疾病。常见病因是盲肠和乙状结肠扭转,较少见的是假性梗阻。本文报道了一例因妊娠期间粘连带导致大肠梗阻且诊断困难的罕见病例。

方法

报告一例妊娠期间大肠梗阻的不寻常病因。

结果

诊断性结肠镜检查证实乙状结肠水平存在大肠梗阻。剖腹手术显示梗阻是由一条源于既往阑尾切除术部位的单一粘连带引起的。切断粘连带解除了梗阻。

结论

对于妊娠期间大肠梗阻的诊断,尤其是有腹部或盆腔手术史的女性,必须保持高度怀疑。结肠镜检查有助于避免对胎儿和母亲进行辐射。及时的手术干预可降低风险,并最大程度提高母婴获得良好结局的机会。

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