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新冠病毒感染患者剖宫产术后多发结肠穿孔:病例系列报道

Postpartum Multiple Colon Perforation after Cesarean Section in COVID-19 Patients: A Case Series.

作者信息

Mirzaie Monireh, Lotfi Sara, Yazdi Zahra, Asgarian Azadeh, Savari Marzieh

机构信息

Department of Obstetrics and Gynecology, Clinical Research Development Unit, School of Medicine, Qom, Iran.

Department of Nursing, Clinical Research Development Unit, Nekouei-Hedayati-Forghani Hospital, Qom University of Medical Sciences, Qom, Iran.

出版信息

J West Afr Coll Surg. 2022 Oct-Dec;12(4):130-135. doi: 10.4103/jwas.jwas_170_22. Epub 2022 Nov 23.

DOI:10.4103/jwas.jwas_170_22
PMID:36590786
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9802594/
Abstract

INTRODUCTION

Gastrointestinal symptoms are present in 50% of polymerase chain reaction (PCR)-positive COVID-19 patients. In addition, bowel abnormalities are a common finding of COVID-19, and bowel-wall disorder is reported in 31% of computed tomography images of COVID-19 patients.

CASE HISTORY

We report three postpartum cases with colon perforation after Cesarean section and positive PCR for SARS-CoV-2-RNA and during the main peak of COVID-19 pandemic, who were managed by early detection, laparotomy, and effective treatment and were discharged and followed up.

CONCLUSION

A colonic perforation could be considered as one of the causes of abdominal pain especially in women with a past surgical history as well as patients with infectious diseases such as COVID-19. Therefore, abdominal and pelvic ultrasound or x-ray was strongly recommended for postpartum women with abnormal abdominal distension, gastrointestinal symptoms, and pain to prevent possible fetal complications.

摘要

引言

50%的聚合酶链反应(PCR)检测呈阳性的新冠肺炎患者存在胃肠道症状。此外,肠道异常是新冠肺炎的常见表现,在新冠肺炎患者31%的计算机断层扫描图像中报告有肠壁紊乱。

病例史

我们报告了3例剖宫产术后结肠穿孔且SARS-CoV-2-RNA的PCR检测呈阳性的产后病例,这些病例发生在新冠肺炎大流行的主要高峰期,通过早期检测、剖腹手术和有效治疗进行处理,随后出院并接受随访。

结论

结肠穿孔可被视为腹痛的原因之一,尤其是对于有既往手术史的女性以及患有新冠肺炎等传染病的患者。因此,强烈建议对有腹胀异常、胃肠道症状和疼痛的产后女性进行腹部和盆腔超声或X光检查,以预防可能的胎儿并发症。

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本文引用的文献

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Gastric Perforation as a Complication of COVID-19 Infection: A Case Report.新型冠状病毒肺炎感染并发症之胃穿孔:一例报告
Cureus. 2022 Apr 1;14(4):e23725. doi: 10.7759/cureus.23725. eCollection 2022 Apr.
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Iatrogenic caecal perforation two days after a caesarean section, a case report.剖宫产术后两天发生医源性盲肠穿孔,一例病例报告。
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Colonic perforation in patients with COVID-19 pneumonia - case reports.COVID-19 肺炎患者的结肠穿孔-病例报告。
Rozhl Chir. 2021 Summer;100(7):353-356. doi: 10.33699/PIS.2021.100.7..
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Acute colonic pseudo-obstruction with bowel rupture after caesarean section in HELLP syndrome: a case report.HELLP 综合征剖宫产术后并发急性结肠假性梗阻并肠破裂:一例报告。
BMC Pregnancy Childbirth. 2020 Nov 25;20(1):727. doi: 10.1186/s12884-020-03414-9.
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COVID-19-Induced Thrombosis in Patients without Gastrointestinal Symptoms and Elevated Fecal Calprotectin: Hypothesis Regarding Mechanism of Intestinal Damage Associated with COVID-19.无胃肠道症状且粪便钙卫蛋白升高的COVID-19患者的血栓形成:关于与COVID-19相关的肠道损伤机制的假说
Trop Med Infect Dis. 2020 Sep 16;5(3):147. doi: 10.3390/tropicalmed5030147.
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Bowel perforation in a Covid-19 patient: case report.新冠患者肠穿孔:病例报告。
Int J Colorectal Dis. 2020 Sep;35(9):1797-1800. doi: 10.1007/s00384-020-03627-6. Epub 2020 May 27.
10
Abdominal Imaging Findings in COVID-19: Preliminary Observations.COVID-19 的腹部影像学表现:初步观察。
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