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妊娠期胆固醇沉着症所致腹痛与呕吐

Abdominal pain and vomiting during pregnancy due to cholesterolosis.

作者信息

van Limburg Stirum Emilie Vj, van Pampus Maria G, Jansen Jeroen M, Janszen Erica Wm

机构信息

Department of Obstetrics and Gynecology, OLVG, Amsterdam, The Netherlands.

Department of Gastro-enterology, OLVG, Amsterdam, The Netherlands.

出版信息

BMJ Case Rep. 2019 Mar 20;12(3):e227826. doi: 10.1136/bcr-2018-227826.

Abstract

We present a 22-year-old pregnant woman at 15 weeks of gestation, with abdominal pain and vomiting. We demonstrate that diagnosis and treatment of vomiting and abdominal pain in pregnancy can be difficult. Therefore, involvement of other medical specialists is important when common treatments fail. Cholesterolosis can cause symptoms similar to those caused by cholelithiasis. Controversial to gallstones, identification of cholesterolosis by ultrasound is hard. Cholecystectomy is the only effective treatment option for cholesterolosis and can be performed safely during pregnancy. Cholecystectomy in pregnancy should be considered if, despite atypical symptoms, gallbladder disease is suspected and other diagnoses are ruled out. This may reduce recurrent symptoms, hospital admissions, exposure to harmful drugs and obstetric complications.

摘要

我们报告一名妊娠15周的22岁孕妇,伴有腹痛和呕吐。我们证明,妊娠呕吐和腹痛的诊断与治疗可能具有挑战性。因此,当常规治疗无效时,其他医学专家的参与很重要。胆固醇沉着症可引起与胆石症相似的症状。与胆结石不同的是,通过超声识别胆固醇沉着症很困难。胆囊切除术是胆固醇沉着症唯一有效的治疗选择,并且可以在孕期安全进行。如果尽管症状不典型,但怀疑有胆囊疾病且排除了其他诊断,则应考虑在孕期行胆囊切除术。这可能会减少复发症状、住院次数、有害药物暴露及产科并发症。

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本文引用的文献

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SAGES guidelines for the use of laparoscopy during pregnancy.SAGES关于孕期腹腔镜检查使用的指南。
Surg Endosc. 2017 Oct;31(10):3767-3782. doi: 10.1007/s00464-017-5637-3. Epub 2017 Jun 22.
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J Surg Res. 2016 Feb;200(2):467-72. doi: 10.1016/j.jss.2015.08.037. Epub 2015 Aug 28.
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Laparoscopy in cholecysto-choledocholithiasis.腹腔镜胆囊-胆总管结石病。
Best Pract Res Clin Gastroenterol. 2014 Feb;28(1):195-209. doi: 10.1016/j.bpg.2013.11.015. Epub 2013 Dec 6.

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