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子宫内肠扭转:一例报告。

Intrauterine Volvulus: A Case Report.

作者信息

Yang Tzu-Yao, Chen Wei-Chih

机构信息

Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, TWN.

出版信息

Cureus. 2023 Oct 26;15(10):e47712. doi: 10.7759/cureus.47712. eCollection 2023 Oct.

Abstract

Intrauterine volvulus is an extremely rare disorder. Its diagnosis is difficult to make antenatally, unless typical pictures are obtained. Owing to its high morbidity and mortality, intensive monitoring of the fetal condition is mandatory. Here, we report a patient, gravida 4, para 1 (G4P1), who had suffered from preterm labor and diminishing fetal movement and was brought to the emergency unit after her 35th week of pregnancy. Ultrasonography was performed to reveal a fetus with a markedly distended bowel (18 mm in width). Intestinal obstruction related to intrauterine volvulus was highly suspected. The fetus was delivered via Cesarean section because of its deteriorated abdominal condition. Urgent exploratory laparotomy was done by a pediatric surgeon to relieve the bowel obstruction on the second day after birth, on the account of poor improvement of the newborn. The newborn did well after segmental resection and was subsequently followed up at the pediatric outpatient clinic. In conclusion, early detection, intensive monitoring, prompt delivery, and urgent surgical intervention are the key to save the fetal life and neonatal health.

摘要

子宫内肠扭转是一种极其罕见的病症。除非获得典型图像,否则产前很难做出诊断。由于其高发病率和高死亡率,对胎儿状况进行密切监测是必不可少的。在此,我们报告一例患者,孕4产1(G4P1),她曾出现早产和胎动减少,在怀孕35周后被送往急诊室。超声检查显示胎儿肠道明显扩张(宽度达18毫米)。高度怀疑存在与子宫内肠扭转相关的肠梗阻。由于胎儿腹部状况恶化,通过剖宫产分娩。由于新生儿情况改善不佳,小儿外科医生在出生后第二天进行了紧急剖腹探查术以解除肠梗阻。新生儿在节段性切除术后情况良好,随后在儿科门诊进行随访。总之,早期发现、密切监测、及时分娩和紧急手术干预是挽救胎儿生命和新生儿健康的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb0/10676236/c807dd2ef74f/cureus-0015-00000047712-i01.jpg

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