Acute gastric incarceration from thoracic herniation in pregnancy following laparoscopic antireflux surgery.

Autor: Brygger L; Department of Obstetrics & Gynaecology, Odense University Hospital, Denmark., Fristrup CW, Harbo FS, Jørgensen JS
Jazyk: angličtina
Zdroj: BMJ case reports [BMJ Case Rep] 2013 Feb 01; Vol. 2013. Date of Electronic Publication: 2013 Feb 01.
DOI: 10.1136/bcr-2012-008391
Abstrakt: Diaphragmatic hernia is a rare complication in pregnancy which due to misdiagnosis or management delays may be life-threatening. We report a case of a woman in the third trimester of pregnancy who presented with sudden onset of severe epigastric and thoracic pain radiating to the back. Earlier in the index pregnancy, she had undergone laparoscopic antireflux surgery (ARS) for a hiatus hernia because of severe gastro-oesophageal reflux. Owing to increasing epigastric pain a CT scan was carried out which diagnosed wrap disruption with gastric herniation into the thoracic cavity and threatened incarceration. This is, to our knowledge, the first report of severe adverse outcome after ARS during pregnancy, with acute intrathoracic gastric herniation. We recommend the avoidance of ARS in pregnancy, and the need to advise women undergoing ARS of the postoperative risks if pregnancy occurs within a few years of ARS.
Databáze: MEDLINE