Ischaemic bowel perforation secondary to a gravid uterus in a patient with treated inflammatory bowel disease and an ileoanal pouch: a case report.
Ann R Coll Surg Engl
; 103(5): e151-e155, 2021 May.
Article
in English
| MEDLINE | ID: covidwho-1238751
ABSTRACT
The diagnosis of visceral perforation during pregnancy is often delayed and the management complex. A 32-year-old primigravid woman in her second trimester presented with abdominal pain and a pre-existing ileoanal pouch. Initial imaging was negative but later imaging was suggestive of serious pathology. At laparotomy, a caesarean section was performed. Peritonitis was encountered secondary to two discrete perforations in the small bowel separate from her pouch. Histology found an ischaemic perforation secondary to a pressure effect from the gravid uterus. In pregnancy, ileoanal pouches may make the interconnected bowel vulnerable to the pressure effect of the gravid uterus and perforation. Pregnant women with such a surgical history who develop symptoms suggestive of bowel perforation should have rapid imaging and their clinical team should consider early definitive surgical intervention.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pregnancy Complications
/
Inflammatory Bowel Diseases
/
Colonic Pouches
/
Intestinal Perforation
/
Ischemia
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
English
Journal:
Ann R Coll Surg Engl
Year:
2021
Document Type:
Article
Affiliation country:
Rcsann.2020.7143
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