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妊娠合并乙状结肠扭转:一例病例报告并文献复习

Pregnancy with sigmoid volvulus: A case report with literature review.

作者信息

Dhar Hansa, Ahuja Kamal, Nimre Eman Alyon, Khan Shreen Ayesha, Arif Mazin Abdulla, Hamdi İlham

机构信息

Nizwa Hospital, Clinic of Obstetrics and Gynecology, Nizwa, Oman.

Nizwa Hospital, Clinic of General Surgery, Nizwa, Oman.

出版信息

Turk J Obstet Gynecol. 2015 Jun;12(2):114-117. doi: 10.4274/tjod.32767. Epub 2015 Jun 15.

Abstract

Sigmoid volvulus refers to torsion of a segment of the alimentary tract, which often leads to bowel obstruction and ischemic changes. Sigmoid volvulus is an acute surgical emergency because delay in diagnosis and management can cause adverse maternal and fetal complications. Sigmoid volvulus typically presents with acute-on-chronic abdominal distension that may develop slowly over 3-4 days. An early and effective resuscitation with fluid replacement, electrolyte balance correction, prophylactic antibiotics and nasogastric decompression is necessary. The standard goals of treatment are to relieve the obstruction, avoid colonic ischemia, and prevent recurrence either by endoscopic decompression or resection with primary anastomosis. A pregnant woman with sigmoid volvulus at 34 weeks and 1 day of gestation presented to our hospital with abdominal pain, vomiting, and constipation. The patient was jointly surgically managed with laparotomy, cesarean section, and detorsion of the sigmoid volvulus, and was discharged in a healthy state on the 5 postoperative day.

摘要

乙状结肠扭转是指消化道某一段的扭转,常导致肠梗阻和缺血性改变。乙状结肠扭转是一种急性外科急症,因为诊断和治疗的延迟可导致母婴不良并发症。乙状结肠扭转通常表现为慢性腹部膨胀急性发作,可能在3 - 4天内缓慢发展。早期进行有效的复苏,包括液体补充、电解质平衡纠正、预防性使用抗生素和鼻胃管减压是必要的。治疗的标准目标是解除梗阻,避免结肠缺血,并通过内镜减压或一期吻合切除术预防复发。一名妊娠34周零1天的乙状结肠扭转孕妇因腹痛、呕吐和便秘入住我院。患者接受了剖腹手术、剖宫产和乙状结肠扭转复位的联合手术治疗,并于术后第5天康复出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1b6/5558374/c3a562b593d3/TJOD-12-114-g1.jpg

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