Wilson Reece Eric, Reali-Marini Diane
Kent Hospital Emergency Department, Department of Emergency Medicine, Warwick, RI.
J Educ Teach Emerg Med. 2020 Jan 15;5(1):V4-V7. doi: 10.21980/J87H19. eCollection 2020 Jan.
Intestinal obstruction complicating pregnancy is a surgical emergency associated with a high incidence of morbidity and mortality for both the mother and fetus. This case report discusses the presentation and treatment of a young female in her third trimester of pregnancy at a repeat visit to the emergency department (ED) with right-sided abdominal pain. She was diagnosed with ileal intussusception secondary to a Meckel's diverticulum with associated small bowel obstruction (SBO) seen on computerized tomography (CT) imaging. She underwent surgical reduction of the invaginated bowel and diverticulectomy. Making a diagnosis of intestinal intussusception during pregnancy is particularly difficult because common symptoms of intestinal obstruction such as anorexia, nausea, vomiting and abdominal pain are encountered frequently during a normal pregnancy.1 Diagnosis is often delayed during pregnancy due to physician hesitancy over the radiation risk to the fetus. While the gold standard for diagnosis is a barium enema, it is often identified on CT scan in adults, and it is regularly managed with surgery.2.
Intussusception, small bowel obstruction, pregnancy, Meckel's diverticulum.
妊娠期肠梗阻是一种外科急症，母婴发病率和死亡率均较高。本病例报告讨论了一名妊娠晚期年轻女性再次就诊于急诊科时出现右侧腹痛的临床表现及治疗情况。她被诊断为梅克尔憩室继发回肠套叠，计算机断层扫描（CT）成像显示伴有小肠梗阻（SBO）。她接受了套叠肠管手术复位及憩室切除术。孕期诊断肠套叠尤为困难，因为肠梗阻的常见症状如厌食、恶心、呕吐和腹痛在正常孕期也经常出现。由于医生对胎儿辐射风险的顾虑，孕期诊断往往会延迟。虽然诊断的金标准是钡灌肠，但在成人中通常通过CT扫描确诊，且通常采用手术治疗。
肠套叠、小肠梗阻、妊娠、梅克尔憩室。
