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自然阴道分娩后导致结肠穿孔的产后急性假性肠梗阻(奥吉尔维综合征)

Postpartum Acute Pseudo-Obstruction of the Colon (Ogilvie's Syndrome) Leading to Perforation After Spontaneous Vaginal Delivery.

作者信息

Yawar Khadija, Virk Hamza N, Ejaz M Sohaib, Rizvi Nabiha N, Chaudhry Wasif M

机构信息

Nephrology, Ghurki Trust and Teaching Hospital, Lahore, PAK.

Nephrology, Farooq Hospital, Lahore, PAK.

出版信息

Cureus. 2024 Nov 2;16(11):e72881. doi: 10.7759/cureus.72881. eCollection 2024 Nov.

Abstract

Acute pseudo-obstruction of the colon (Ogilvie's syndrome) leading to perforation is a rare post-surgical complication. Most commonly associated with cesarean sections, only one case has been previously reported in the literature that occurred after normal vaginal delivery. We present the case of a 31-year-old female who presented on the seventh day following spontaneous vaginal delivery with abdominal distension, intermittent episodes of watery diarrhea, and sudden severe generalized abdominal pain. Radiological imaging showed evidence of pneumoperitoneum and perforation of the bowel. A right-sided hemicolectomy was performed after an exploratory laparotomy revealed perforation of the cecum. Initially considered a diagnosis of exclusion, Ogilvie's syndrome is a rare and multifactorial post-surgical complication. This case report emphasizes the significance of early detection and initiation of treatment, which can minimize the possibility of developing mortality-associated sequelae of this disease.

摘要

导致穿孔的急性结肠假性梗阻(奥吉尔维综合征)是一种罕见的术后并发症。最常与剖宫产相关,此前文献中仅报道过1例发生于正常阴道分娩后的病例。我们报告1例31岁女性,在自然阴道分娩后第7天出现腹胀、间歇性水样腹泻及突发严重的全腹疼痛。影像学检查显示有气腹和肠穿孔迹象。剖腹探查发现盲肠穿孔后,行右侧半结肠切除术。奥吉尔维综合征最初被认为是一种排除性诊断,是一种罕见的、多因素的术后并发症。本病例报告强调了早期发现和开始治疗的重要性,这可以将该疾病相关死亡后遗症的发生可能性降至最低。

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