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妊娠期间无既往手术史的粘连性肠梗阻:1例罕见病例

Band Adhesion Causing Intestinal Obstruction Without Previous Surgery in Pregnancy: A Rare Case.

作者信息

Singh Ritu, Deoraj Anand, Gupta Monika, Pathi Deeptimayee

机构信息

Obstetrics and Gynaecology, Kurji Holy Family Hospital, Patna, IND.

Surgery, Kurji Holy Family Hospital, Patna, IND.

出版信息

Cureus. 2025 Apr 8;17(4):e81873. doi: 10.7759/cureus.81873. eCollection 2025 Apr.

Abstract

Intestinal obstruction (IO) during pregnancy is a rare occurrence. Although uncommon, IO in pregnancy carries a significant risk of maternal and fetal mortality. Diagnosing IO can be challenging, as abdominal pain and vomiting in pregnant patients may be mistaken for labor pain or hyperemesis gravidarum. Early reports strongly recommend exploratory surgery as the standard treatment once IO is diagnosed. The delivery of the baby during the same procedure may be necessary if the surgical emergency jeopardizes the pregnancy. However, this approach is not ideal if the pregnancy is not at term. In recent years, some cases have demonstrated that small bowel intestinal obstruction (SBIO) can be managed conservatively. In our case, we successfully managed the patient conservatively before performing an exploratory laparotomy and lower segment cesarean section in the same setting to prevent maternal and fetal complications. IO without prior surgery is rare, and even more so during pregnancy. Our case highlights a rare instance of pregnancy-related IO caused by band adhesions in the absence of previous surgical history.

摘要

妊娠期肠梗阻(IO)是一种罕见的情况。虽然不常见,但妊娠期IO具有导致母婴死亡的重大风险。诊断IO可能具有挑战性,因为孕妇的腹痛和呕吐可能被误诊为宫缩痛或妊娠剧吐。早期报告强烈建议一旦诊断出IO,将 exploratory surgery 作为标准治疗方法。如果手术急症危及妊娠,则可能需要在同一手术过程中分娩婴儿。然而,如果妊娠未足月,这种方法并不理想。近年来,一些病例表明小肠肠梗阻(SBIO)可以保守治疗。在我们的病例中,我们在同一环境中进行 exploratory laparotomy 和下段剖宫产之前,成功地对患者进行了保守治疗,以预防母婴并发症。无前次手术史的IO很少见,在妊娠期更是如此。我们的病例突出了一例罕见的与妊娠相关的IO,其由无既往手术史的带状粘连引起。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5098/12059609/0277f2ceac15/cureus-0017-00000081873-i01.jpg

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