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妊娠期以便秘为表现的结直肠癌

Colorectal Cancer Presenting with Constipation During Pregnancy.

作者信息

Jones Adriana, Povlow Michael R

机构信息

Medical Student, University of Central Florida College of Medicine.

出版信息

Cureus. 2017 Apr 25;9(4):e1190. doi: 10.7759/cureus.1190.

Abstract

Colorectal cancer is a rare occurrence during pregnancy and can present with symptoms that are common during pregnancy such as constipation.This can make the diagnosis of colorectal cancer during pregnancy difficult. Management of colorectal cancer during pregnancy is similar to the treatment of non-pregnant patients, but with fetal safety in mind. This case report describes a 33-year-old female gravida two para one (G2P1) at 29 weeks gestation who presented with a complete bowel obstruction. Colonoscopy, magnetic resonance imaging (MRI) and later resection showed an obstructing malignancy which was then resected through an exploratory laparotomy with left hemicolectomy. Postoperatively, there was a concern for sepsis, so labor was induced and the baby was delivered vaginally. The patient then continued with chemotherapy with hematology-oncology. High clinical suspicion is needed to diagnose colorectal cancer during pregnancy. Once diagnosed, surgery can be considered if resectable, taking into account gestational age. Fetal safety is a major consideration during treatment.

摘要

结直肠癌在孕期较为罕见,其症状可能与孕期常见症状如便秘相似。这使得孕期结直肠癌的诊断颇具难度。孕期结直肠癌的管理与非孕期患者的治疗相似,但要考虑胎儿安全。本病例报告描述了一名33岁、孕29周、孕2产1(G2P1)的女性,她出现了完全性肠梗阻。结肠镜检查、磁共振成像(MRI)以及后续的切除术显示为梗阻性恶性肿瘤,随后通过剖腹探查术加左半结肠切除术将其切除。术后,患者担心发生败血症,因此引产,婴儿经阴道分娩。随后患者继续接受血液肿瘤学的化疗。孕期诊断结直肠癌需要高度的临床怀疑。一旦确诊,如果肿瘤可切除,可考虑手术,同时要考虑孕周。治疗期间胎儿安全是主要考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9e6/5444916/ccb8d2ce7f82/cureus-0009-00000001190-i01.jpg

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