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病例报告:一名孕晚期孕妇肠道穿孔的罕见病因。

Case report: A rare cause of intestinal perforation in a third-trimester pregnant woman.

作者信息

Stiegler Clemens, Kapitza Christopher, Weber Florian, Patalakh Wladimir, Schäfer Claus

机构信息

Medical Department II, Klinikum Neumarkt, Neumarkt in der Oberpfalz, Germany.

Institute of Pathology, University of Regensburg, Regensburg, Germany.

出版信息

Front Med (Lausanne). 2024 Jul 3;11:1387043. doi: 10.3389/fmed.2024.1387043. eCollection 2024.

Abstract

BACKGROUND

An acute abdomen is a medical emergency that requires early diagnosis and treatment. In pregnancy, this process is significantly more challenging, and radiological findings are sometimes unclear due to the enlarged uterus displacing other structures. Moreover, endometriosis-related complications are rare, and the disease is often undiagnosed.

CASE PRESENTATION

We report a case of acute perforation of the cecum and appendix during pregnancy (35 weeks of gestation) caused by a previously unknown, deep infiltrating endometriosis with focal ulceration of the affected bowel wall, which sonographically seemed to be acute appendicitis.

CONCLUSION

Despite the relatively low risk, clinicians should be aware of possible endometriosis-associated complications in pregnancy with potentially life-threatening events, even in previously unknown endometriosis. Further studies should evaluate intestinal complications during pregnancy in relation to previous treatment of intestinal endometriosis (conservative vs. surgical).

摘要

背景

急腹症是一种需要早期诊断和治疗的医疗急症。在孕期,这个过程更具挑战性,由于增大的子宫推移其他结构,影像学检查结果有时不明确。此外,子宫内膜异位症相关并发症罕见,该病常未被诊断出来。

病例报告

我们报告一例妊娠(孕35周)期间盲肠和阑尾急性穿孔病例,病因是此前未知的深部浸润性子宫内膜异位症,伴有受累肠壁局灶性溃疡,超声检查时看似急性阑尾炎。

结论

尽管风险相对较低,但临床医生应意识到孕期可能出现与子宫内膜异位症相关的、甚至可能危及生命的事件,即便此前未知有子宫内膜异位症。进一步研究应评估孕期肠道并发症与既往肠道子宫内膜异位症治疗(保守治疗与手术治疗)的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dc5/11251912/7d75244bea8d/fmed-11-1387043-g001.jpg

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