Chan Chia-Meng, Chen Wei-Lung, Chen Jiann-Hwa, Wu Yung-Lung, Huang Chien-Cheng
Department of Emergency Medicine, Cathay General Hospital, Taipei, Taiwan.
Med Princ Pract. 2009;18(5):422-4. doi: 10.1159/000226300. Epub 2009 Jul 31.
We present a case of acute intestinal infarction in a pregnant woman with chronic idiopathic mesenteric vein thrombosis (MVT) under regular anticoagulation treatment.
The condition of the 26-year-old woman who was diagnosed with chronic idiopathic MVT after detailed investigation was stable after receiving regular anticoagulation with warfarin. One year later, she presented with a 7-day episode of intermittent epigastric pain. Acute intestinal infarction and concomitant 7-week pregnancy were diagnosed. To preserve her life, a dilation and curettage procedure and emergency laparotomy with bowel resection were performed. Ten days later, she was discharged, having made a good recovery.
Although pregnancy was not the primary cause of chronic MVT, it did play a role in inducing the acute intestinal infarction. This case indicates that pregnant patients with known chronic idiopathic MVT should be counseled about the high risk of acute mesenteric thrombosis. This case also serves to remind physicians that there should always be a high level of suspicion of intestinal infarction in patients with an acute abdomen who are in a hypercoagulable state.
我们报告一例在接受常规抗凝治疗的慢性特发性肠系膜静脉血栓形成(MVT)孕妇中发生急性肠梗死的病例。
该26岁女性经详细检查后被诊断为慢性特发性MVT,接受华法林常规抗凝治疗后病情稳定。一年后,她出现了为期7天的间歇性上腹部疼痛。诊断为急性肠梗死并伴有7周妊娠。为挽救其生命,进行了刮宫术和急诊剖腹肠切除术。十天后,她康复出院。
虽然妊娠不是慢性MVT的主要病因,但在诱发急性肠梗死中确实起了作用。该病例表明,对于已知慢性特发性MVT的孕妇,应告知其急性肠系膜血栓形成的高风险。该病例还提醒医生,对于处于高凝状态的急腹症患者,应始终高度怀疑肠梗死。