Tanabe Hanami, Harada Taku, Nakai Mori
Center of Postgraduate Clinical Training, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Department of General Medicine, Nerima Hikarigaoka Hospital, 2-5-1 Hikarigaoka Nerima-ku, Tokyo 179-0072, Japan.
Radiol Case Rep. 2023 May 6;18(7):2424-2426. doi: 10.1016/j.radcr.2023.04.011. eCollection 2023 Jul.
Acute abdominal pain in pregnant women may complicate the diagnostic process of acute abdominal pain because of anatomical and physiological changes and limitations of computed tomography examinations related to radiation exposure. Here, we present the case of a 35-year-old female in her 10th week of pregnancy who was seen in the emergency department with unilateral abdominal pain and gross hematuria. Ultrasound detected only hydronephrosis and failed to identify ureteral stones, but magnetic resonance imaging revealed a diagnosis of idiopathic renal hemorrhage and intraductal ureteral hematoma, not ureteral stones. Although magnetic resonance imaging for pregnant women has the disadvantages of prolonged scan time and difficulty in image interpretation, no harm or complications to the mother or fetus have been reported. Magnetic resonance imaging may be considered in assessing acute abdominal pain in pregnant women, especially when the diagnosis is uncertain, based on shared decision-making with the patient and assessing the clinical situation and availability.
孕妇的急性腹痛可能会使急性腹痛的诊断过程复杂化,这是由于解剖学和生理学变化以及计算机断层扫描检查因辐射暴露而存在局限性。在此,我们报告一例35岁处于妊娠第10周的女性病例,该患者因单侧腹痛和肉眼血尿在急诊科就诊。超声仅检测到肾积水,未能发现输尿管结石,但磁共振成像显示诊断为特发性肾出血和输尿管内血肿,而非输尿管结石。尽管孕妇磁共振成像存在扫描时间长和图像解读困难的缺点,但尚未有对母亲或胎儿造成伤害或并发症的报道。在与患者共同决策并评估临床情况和可行性的基础上,对于评估孕妇的急性腹痛,尤其是诊断不明确时,可考虑使用磁共振成像。