Covali Roxana, Ambrosie Lucian, Onofriescu Micea, Luca Alexandru, Dumachita-Sargu Gabriela, Aursulesei Violeta, Gafitanu Dumitru
Radiologist at the Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania.
Surgeon at the Sf Spiridon Emergency Clinical Hospital Iasi in Romania.
Perm J. 2017;21:16-179. doi: 10.7812/TPP/16-179.
Intussusception usually is associated with children, rarely with adults.
A 42-year-old pregnant woman (29 weeks' gestation) reported mild pain in the upper aspect of the abdomen after an intense physical effort. Ultrasound examination found a normally evolving pregnancy and a bowel obstacle, without bowel distention. Because it was not a surgical emergency at the time of evaluation, she was sent to the hospital's Obstetrics Department. The patient's symptoms worsened the next day. Ultrasound examination revealed dilated bowel loops and free fluid. Strangulated epigastric hernia was suspected. Computed tomography was not performed. Exploratory laparotomy revealed a small-bowel intussusception, which was successfully manually reduced, and no leading point was found. Four days later, she delivered a premature baby boy. Two days later the necrotized reduced ileal loop had to be surgically removed because of the patient's altered status. After this procedure, the patient's recovery was uneventful.
To our knowledge, this is the first case of small-bowel intussusception in a pregnant woman reported in the literature.
肠套叠通常与儿童相关,很少见于成人。
一名42岁孕妇(孕29周)在剧烈体力活动后出现上腹部轻度疼痛。超声检查发现妊娠进展正常,但存在肠梗阻,无肠扩张。由于评估时并非手术急症,她被送往医院产科。次日患者症状加重。超声检查显示肠袢扩张及游离液体。怀疑为绞窄性上腹疝。未行计算机断层扫描。剖腹探查发现小肠肠套叠,成功手法复位,未发现引导点。四天后,她产下一名早产男婴。两天后,由于患者病情变化,坏死的复位回肠袢不得不手术切除。术后,患者恢复顺利。
据我们所知,这是文献报道的首例孕妇小肠肠套叠病例。