Silva Ana Cristina, Moreira Pedro Soares, Simões Vitor Costa, Sampaio Mónica, Santos Marisa Domingues
Colorectal Unit, Surgery Department, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001, Porto, Portugal.
J Surg Case Rep. 2020 Dec 31;2020(12):rjaa554. doi: 10.1093/jscr/rjaa554. eCollection 2020 Dec.
Abdominal pain in a pregnant woman with a history of laparoscopic Roux-en-Y gastric bypass (LRYGB) in the emergency department is challenging. Intussusception is a rare cause of small bowel obstruction after LRYGB and can lead to intestinal necrosis, perforation, sepsis and death. The authors report a case of a 34-week pregnant patient, previously submitted to LRYGB, presenting to the emergency department with abdominal pain and vomiting. A computed tomography scan suggested the presence of ileoileal intussusception. So, an emergent laparotomy was performed with invagination reduction. The postoperative period was uneventful, as well as pregnancy and caesarian performed 4 weeks after surgery. At the 45-month follow-up, there was no recurrence of intussusception.
对于一名有腹腔镜Roux-en-Y胃旁路术(LRYGB)病史的孕妇,在急诊科出现腹痛是一个具有挑战性的问题。肠套叠是LRYGB术后小肠梗阻的罕见原因,可导致肠坏死、穿孔、败血症和死亡。作者报告了一例34周妊娠患者,既往接受过LRYGB手术,因腹痛和呕吐就诊于急诊科。计算机断层扫描提示存在回肠-回肠套叠。因此,急诊行剖腹探查术并进行肠套叠复位。术后恢复顺利,术后4周妊娠及剖宫产也顺利。在45个月的随访中,肠套叠未复发。