Vo Thi M, Gyaneshwar Rajat, Mayer Christiane
O & G Department, Liverpool Hospital, Liverpool, New South Wales, Australia.
J Obstet Gynaecol Res. 2008 Aug;34(4 Pt 2):658-62. doi: 10.1111/j.1447-0756.2008.00903.x.
Sigmoid volvulus in pregnancy is a rare complication. The combination of sigmoid volvulus and sigmoid herniation through a broad ligament together with placental abruption in pregnancy is a most unusual obstetrical emergency. We report the case of a previously well 32-year-old Mexican woman who was transferred to our institution at 28 weeks gestation with threatened preterm labor. We considered the possibility of appendicitis. While awaiting a surgical consult, an emergency cesarean section was carried out for a prolonged deceleration of the fetal heart. A routine transverse suprapubic abdominal entry revealed a large loop of ischemic bowel. This was confirmed to be a sigmoid volvulus which had herniated through a left broad ligament defect. The deceleration was attributed to a large placental abruption. No previous case with a combination of a sigmoid volvulus and placental abruption was found in the literature.
妊娠期间乙状结肠扭转是一种罕见的并发症。乙状结肠扭转合并乙状结肠通过阔韧带疝出以及妊娠期间胎盘早剥是一种极为罕见的产科急症。我们报告一例病例，一名32岁既往健康的墨西哥女性，孕28周时因先兆早产被转诊至我院。我们考虑了阑尾炎的可能性。在等待外科会诊期间，因胎儿心率长时间减速而行急诊剖宫产。常规耻骨上横切口入腹后发现一大段缺血肠管。经证实这是一段通过左侧阔韧带缺损疝出的乙状结肠扭转。心率减速归因于大面积胎盘早剥。文献中未发现乙状结肠扭转与胎盘早剥合并存在的既往病例。
