Yin Yuzhu, Li Chuo, Xu Chengfang, Wu Lingling, Deng Ni, Hou Hongying, Wu Bin
Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
J Pak Med Assoc. 2017 Feb;67(2):308-310.
Intestinal obstruction due to congenital intestinal malrotation is usually diagnosed in neonates but may, in rare cases, occur during pregnancy. The absence of specific symptoms in combination with its low incidence makes timely detection of intestinal malrotation-related obstruction difficult in expectant mothers. We present a rare case of a 23-year-old woman with a twin pregnancy following in vitro fertilization-embryo transfer (IVF-ET) who presented with symptoms of intestinal obstruction at 22+4 weeks of gestation. This diagnosis was not confirmed by imaging and the patient was managed conservatively. Following caesarean section, she gave birth to two healthy full-term infants. During the operation, malposition of the bowel and the typical Ladd's band confirmed intestinal malrotation. This is the first report of a congential malrotation complicating a multiple pregnancy, and highlights that malrotation without volvulus can be managed conservatively.
先天性肠旋转不良所致肠梗阻通常在新生儿期被诊断，但在极少数情况下可能发生于孕期。由于缺乏特异性症状且发病率低，期待中的母亲很难及时发现与肠旋转不良相关的肠梗阻。我们报告一例罕见病例，一名23岁体外受精 - 胚胎移植（IVF - ET）后的双胎妊娠女性，在妊娠22 + 4周时出现肠梗阻症状。影像学检查未确诊，患者接受保守治疗。剖宫产术后，她产下两名健康的足月婴儿。手术中，肠管位置异常及典型的Ladd束证实了肠旋转不良。这是先天性肠旋转不良并发多胎妊娠的首例报告，并强调无肠扭转的肠旋转不良可保守治疗。
