Ribeiro Nascimento Enzo Fabrício, Chechter Michelle, Fonte Fábio Piovezan, Puls Nara, Valenciano Juliana Santos, Fernandes Filho Cláudio Luciano Penna, Nonose Ronaldo, Bonassa Crhistiny Emmanuelle Gabriel, Martinez Carlos Augusto Real
Department of General Surgery, São Francisco University Hospital, Bragança Paulista, SP, Brazil.
Case Rep Obstet Gynecol. 2012;2012:641093. doi: 10.1155/2012/641093. Epub 2012 Feb 9.
Colonic obstruction due to sigmoid colon volvulus during pregnancy is a rare but complication with significant maternal and fetal mortality. We describe a case of sigmoid volvulus in a patient with 33 weeks of gestation that developed complete necrosis of the left colon. Case. 27-year-old woman was admitted with 3 days of abdominal distention, vomit, and the stoppage of the passage of gases and feces. She was admitted with poor clinical conditions with septic shock, acute respiratory distress syndrome, and signs of diffuse peritonitis. Abdominal radiography showed severe dilation of the colon with horseshoe signal suggesting a sigmoid volvulus, pneumoperitoneum and we could not we could not identify fetal heartbeats. With a diagnosis of complicate sigmoid volvulus she was underwent to the laparotomy where we found necrosis of all descending colon due to double twist volvulus of the sigmoid. We performed a colectomy with a confection of a proximal colostomy, and closing of the rectal stump. Due to an uncontrollable uterine bleeding during cesarean due, it was required a hysterectomy. The patient had an uneventful postoperative course thereafter and was discharged on a regular diet on the 15th postoperative day.
妊娠期乙状结肠扭转导致的结肠梗阻是一种罕见但具有显著母婴死亡率的并发症。我们描述了一例妊娠33周的患者发生乙状结肠扭转，导致左半结肠完全坏死的病例。病例：一名27岁女性因腹胀、呕吐、停止排气排便3天入院。入院时临床状况不佳，伴有感染性休克、急性呼吸窘迫综合征和弥漫性腹膜炎体征。腹部X线检查显示结肠严重扩张，呈马蹄形信号，提示乙状结肠扭转、气腹，且未发现胎心。诊断为复杂性乙状结肠扭转后，她接受了剖腹手术，术中发现由于乙状结肠双扭转，降结肠全部坏死。我们进行了结肠切除术，同时做了近端结肠造口术，并封闭直肠残端。由于剖宫产术中子宫出血无法控制，需要进行子宫切除术。此后患者术后恢复顺利，术后第15天正常饮食出院。
