Ibrar Faiza, Awan Azra Saeed, Fatima Touseef, Tabassum Hina
Department of Obstetrics & Gynaecology, Foundation University Medical College, Fauji Foundation Hospital, Rawalpindi, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Jul-Sep;29(3):506-508.
A 37-year-old, patient presented in emergency with history of normal vaginal delivery followed by development of abdominal distention, vomiting, constipation for last 3 days. She was para 4 and had normal vaginal delivery by traditional birth attendant at peripheral hospital 3 days back. Imaging study revealed a heterogeneous complex mass, ascites, pleural effusion, air fluid levels with dilatation gut loops. Based upon pelvic examination by senior gynaecologist in combination with ultrasound; a clinical diagnosis of broad ligament haematoma was made. However, vomiting and abdominal distention raised suspicion of intestinal obstruction. Due to worsening abdominal distention exploratory laparotomy was carried out. It was pseudo colonic obstruction and caecostomy was done. Timely intervention by multidisciplinary approach saved patient life with minimal morbidity.
一名37岁患者因紧急情况前来就诊,其病史为顺产,随后在过去3天出现腹胀、呕吐、便秘。她已育有4个孩子,3天前在周边医院由传统接生员进行了顺产。影像学检查显示有一个不均匀的复杂肿块、腹水、胸腔积液、气液平面以及肠袢扩张。根据资深妇科医生的盆腔检查并结合超声检查,做出了阔韧带血肿的临床诊断。然而,呕吐和腹胀引发了肠梗阻的怀疑。由于腹胀加剧,遂进行了剖腹探查术。发现是假性结肠梗阻,并进行了盲肠造口术。多学科方法的及时干预挽救了患者生命,且发病率降至最低。