Acute mesenteric venous thrombosis in a pregnant woman at 35 weeks of gestation: a case report and review of the literature
Autor: | Lina Huang, Liping Li, Xiuting Guan |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Adult
medicine.medical_specialty Abdominal pain Exploratory laparotomy Pregnancy Trimester Third medicine.medical_treatment Pregnancy Complications Cardiovascular Gestational Age Case Report 030230 surgery Anastomosis lcsh:Gynecology and obstetrics Mesenteric Vein Acute abdomen Colon Ascending 03 medical and health sciences 0302 clinical medicine Ileum Pregnancy medicine Humans Fetal Death Colectomy Digestive System Surgical Procedures lcsh:RG1-991 Abdomen Acute Intestinal ischemia Cesarean Section business.industry Obstetrics and Gynecology medicine.disease Thrombosis Surgery Jejunum Mesenteric venous thrombosis Mesenteric Ischemia 030220 oncology & carcinogenesis Acute Disease Vomiting Female medicine.symptom business |
Zdroj: | BMC Pregnancy and Childbirth, Vol 18, Iss 1, Pp 1-6 (2018) BMC Pregnancy and Childbirth |
ISSN: | 1471-2393 |
Popis: | Background Mesenteric venous thrombosis (MVT) is an infrequent thrombotic event that can cause devastating intestinal hemorrhagic ischemia. The mortality rate among patients with acute MVT ranges from 20 to 50%. Occurrence of MVT in pregnancy is quite rare. In this case report, we describe a pregnant woman who presented with acute MVT at 35 weeks of gestation. Case presentation Our case was a 26-year-old primigravid woman at 35 weeks gestation. She presented to Guangzhou First People’s Hospital with complaints of abdominal pain, nausea and vomiting. The second day after admission, she complained of more intense abdominal pain, anorexia, vomiting and abdominal distention that were out of proportion to physical signs. An emergency exploratory laparotomy was performed. The entire ileum, part of the jejunum and part of the ascending colon were gangrenous, and thromboembolism was discovered in the corresponding mesenteric veins. The necrotic intestine was resected and an end-to-end jejunum-colon anastomosis was performed. A cesarean section was performed to remove the placenta and fetus, which had expired. Histopathological analysis revealed extensive edema, hemorrhage, inflammatory infiltration and necrosis in the resected bowel, and widespread thrombosis in mesenteric venous lumens. Conclusion The diagnosis of MVT during pregnancy is very difficult due to its low incidence, and non-characteristic symptoms, signs and laboratory results. MVT may be the underlying cause of severe abdominal pain during pregnancy and should be included in the differential diagnosis of pregnant patients with an acute abdomen. |
Databáze: | OpenAIRE |
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