Campigotto Michele, Braini Andrea, Casarotto Maria Maddalena, Crocè Saveria Lory, Sablich Renato
Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy.
Struttura Complessa Chirurgia Generale, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy.
ACG Case Rep J. 2022 Jun 23;9(6):e00805. doi: 10.14309/crj.0000000000000805. eCollection 2022 Jun.
No detailed information is currently available about the management of pregnancy and delivery in patients with a stoma after colectomy for ulcerative colitis. We describe the case of a young pregnant woman with terminal ileostomy after toxic megacolon. Episodes of stoma occlusion, determined by the enlargement of the uterus, were treated with endoscopic decompression and daily assumption of oral laxatives, making possible to avoid surgery and carry pregnancy on until caesarean section was performed at week 37. Fertility issues, facing pregnancy with ileostomy rather than with ileal pouch-anal anastomosis, and choice of caesarean section rather than vaginal delivery are discussed.
目前尚无关于溃疡性结肠炎结肠切除术后有造口患者妊娠和分娩管理的详细信息。我们描述了一名患有中毒性巨结肠后行末端回肠造口术的年轻孕妇的病例。由子宫增大导致的造口梗阻发作,通过内镜减压和每日服用口服泻药进行治疗,从而有可能避免手术并维持妊娠直至在第37周进行剖宫产。文中还讨论了生育问题、回肠造口而非回肠储袋肛管吻合术面临的妊娠情况,以及剖宫产而非阴道分娩的选择。