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      Small Bowel Ischemia due to Jejunum Volvulus in Pregnancy: A Case Report

      case-report

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          Abstract

          The diagnosis of intestinal obstruction in pregnancy is difficult, as the symptoms may mimic pregnancy-associated complaints. The surgical management is challenging, as the mortality rate of midgut volvulus in pregnancy is high. We report the case of a 35-year-old woman at 21 weeks and 5 days of gestation with small bowel obstruction who presented to our institution with a 24 h history of colicky abdominal pain and nausea and who finally had a successful open repair.

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          MRI of acute abdominal and pelvic pain in pregnant patients.

          Keith Birchard, R C Semelka, Douglas Brown … (2005)
          The purpose of this study was to show the usefulness of MRI in the evaluation of pregnant women with acute abdominal or pelvic pain. All MRI studies of pregnant patients who were referred for examination because of acute abdominal or pelvic pain between June 2002 and May 2004 were included in this study (n=29). The use of MRI was at the discretion of the clinician. Fetal sonography was performed in all patients before any other imaging. A complete abdominal sonographic examination was performed in six patients before MRI. In the remaining 23 patients, MRI was the choice for primary imaging. Multiplanar multisequence MR images of the abdomen and pelvis were obtained in each patient. Unenhanced images were reviewed by an experienced radiologist to determine whether a diagnosis could be made without the administration of gadolinium. In 22 of 29 studies, gadolinium was not administered. The prospective clinical MR interpretations were compared with follow-up medical, surgical, and obstetric records to determine the correctness of the interpretation. All patients were followed up until the date of article submission or until the date of final chart entry. Correlation of prospective clinical MR interpretations with follow-up medical records showed correct identification of disease entities in all but one patient. In one patient, torsion of the ovary was neither described prospectively nor seen in retrospect. The following disease processes were correctly identified using MRI: appendiceal abscess (n=1), appendicitis (n=2), intraabdominal and rectus muscle abscess (n=1), intussusception (n=1), pancreatitis (n=1), ulcerative colitis (n=1), Crohn's disease with diffuse peritoneal inflammation (n=1), bilateral adrenal hemorrhage (n=1), pyelonephritis (n=2), hydronephrosis (n=1), uterine fibroid degeneration (n=2), degeneration and torsion of a submucosal uterine fibroid (n=1), simple ovarian cysts (n=1), and ovarian torsion (n=1). Twelve of the 29 patients had normal findings on MR examinations and unremarkable follow-up. The intrinsic safety of MRI and its ability to accurately show abdominal and pelvic disease in pregnant patients make it highly useful in the evaluation of these patients.
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            Fatal midgut volvulus: a rare cause of gestational intestinal obstruction.

            Prashant Kittad, Anand Gaikwad, Dhananjay Ghongade (2010)
            Malrotation is a congenital abnormality of the gastrointestinal tract that predisposes to midgut volvulus and can lead to small bowel infarction. Midgut volvulus is rare in adulthood and even rarer during pregnancy. If not diagnosed accurately, it carries a high-mortality rate. We present a case of 27-year-old woman with 33 weeks of gestation, who presented with acute abdomen and intrauterine fetal demise. CT angiogram with multidetector row scanner showed the midgut volvulus clearly and unequivocally. Unfortunately, the patient died of septicemia and extensive bowel infarction. CT angiogram images are presented here. To our knowledge, no similar case with gestational midgut volvulus and CT angiogram has been reported previously in the literature.
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              Acute abdomen in pregnancy requiring surgical management a 20-case series

              Aysun Unal, Sema Etiz Sayharman, Leyla Ozel … (2011)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Obstet Gynecol
                Journal ID (iso-abbrev): Case Rep Obstet Gynecol
                Journal ID (publisher-id): CRIM.OBGYN
                Title: Case Reports in Obstetrics and Gynecology
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-6684
                ISSN (Electronic): 2090-6692
                Publication date (Print): 2012
                Publication date (Electronic): 12 December 2012
                Volume: 2012
                Electronic Location Identifier: 485863
                Affiliations
                1Second Department of Surgery, Aretaieion University Hospital, 76 Vas. Sofias Avenue, 11528 Athens, Greece
                2First Department of Anesthesiology, Aretaieion University Hospital, 76 Vas. Sofias Avenue, 11528 Athens, Greece
                3First Department of Obstetrics and Gynecology, Aretaieion University Hospital, 76 Vas. Sofias Avenue, 11528 Athens, Greece
                Author notes

                Academic Editors: L. Nilas, M. A. Osmanagaoglu, and J.-C. Shih

                Article
                DOI: 10.1155/2012/485863
                PMC ID: 3530760
                PubMed ID: 23304583
                SO-VID: c4042620-41e6-4030-93cc-1494c8a56c79
                Copyright © Copyright © 2012 Ioannis Vassiliou et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 30 October 2012
                Date accepted : 2 December 2012
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Obstetrics & Gynecology
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology

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