Parlakgumus Huriye Ayse, Haydardedeoglu Bulent, Alkan Ozlem
Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.
J Obstet Gynaecol Res. 2010 Oct;36(5):1121-4. doi: 10.1111/j.1447-0756.2010.01263.x. Epub 2010 Sep 16.
Aortic dissection is a potentially fatal disease rarely encountered in obstetric clinics. A multiparous woman with a prior cesarean delivery was admitted with the complaint of epigastric pain at 33 weeks of gestation. The patient was diagnosed with preeclampsia and preterm labor. An emergent cesarean delivery was performed. Hypertension and epigastric pain could not be controlled after the operation. Computed tomography scan 2 days after the operation revealed aortic dissection, multiple infarct areas in the spleen and liver, and dilations of the intestine and the colon. Ascending aorta replacement followed by massive intestinal resection starting from the ligament of Trietz to the sigmoid colon was performed. Nine hours after the operation the patient had cardiopulmonary arrest. Aortic dissection should be suspected in cases of atypical epigastric pain even if the patient shows signs of preeclampsia and preterm labor.
主动脉夹层是一种在产科诊所罕见的潜在致命疾病。一名有剖宫产史的经产妇在妊娠33周时因上腹部疼痛入院。患者被诊断为先兆子痫和早产。急诊行剖宫产术。术后高血压和上腹部疼痛无法控制。术后2天的计算机断层扫描显示主动脉夹层、脾脏和肝脏多处梗死灶以及小肠和结肠扩张。行升主动脉置换术,随后从屈氏韧带至乙状结肠进行大范围肠切除术。术后9小时患者发生心肺骤停。即使患者表现出先兆子痫和早产的迹象,对于非典型上腹部疼痛的病例也应怀疑主动脉夹层。