Wang Lan, Zhu Yuchun, Tan Huayun
Department of Obstetrics, Weifang People's Hospital, Shandong Second Medical University, Weifang, China.
Front Med (Lausanne). 2024 Nov 29;11:1479634. doi: 10.3389/fmed.2024.1479634. eCollection 2024.
Internal hernias through mesenteric defects are rare, particularly in the context of twin pregnancies, and can lead to severe complications such as bowel obstruction and strangulation. Early diagnosis is critical, yet challenging, due to the overlapping symptoms with other abdominal conditions and the limited use of advanced imaging during pregnancy.
We present a 33-year-old woman with a twin pregnancy at 33 + 2 weeks of gestation who experienced acute bowel obstruction due to an internal hernia through a congenital mesenteric defect. The patient presented with persistent upper abdominal pain, nausea, and vomiting. Given the advanced stage of pregnancy and the associated risks, a cesarean section was performed, followed by surgical exploration. Approximately one meter of strangulated small intestine was resected, and the mesenteric defect was repaired. Both mother and infants recovered uneventfully.
This case highlights the importance of considering internal hernia in the differential diagnosis of acute abdominal pain during pregnancy. Prompt surgical intervention is crucial to prevent maternal and fetal morbidity.
通过肠系膜缺损形成的内疝很少见，尤其是在双胎妊娠的情况下，并且可能导致严重并发症，如肠梗阻和肠绞窄。由于与其他腹部疾病症状重叠以及孕期先进影像学检查使用受限，早期诊断至关重要但具有挑战性。
我们报告一名33岁双胎妊娠女性，孕33 + 2周，因通过先天性肠系膜缺损形成的内疝导致急性肠梗阻。患者表现为持续性上腹痛、恶心和呕吐。鉴于孕周较大及相关风险，行剖宫产，随后进行手术探查。切除了约一米绞窄的小肠，并修复了肠系膜缺损。母婴均顺利康复。
该病例突出了在孕期急性腹痛鉴别诊断中考虑内疝的重要性。及时的手术干预对于预防母婴发病至关重要。
