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Acute mesenteric venous thrombosis in a pregnant woman at 35 weeks of gestation: a case report and review of the literature.
- Source :
-
BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2018 Dec 11; Vol. 18 (1), pp. 487. Date of Electronic Publication: 2018 Dec 11. - Publication Year :
- 2018
-
Abstract
- 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.<br />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.<br />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.
- Subjects :
- Abdomen, Acute etiology
Abdomen, Acute surgery
Acute Disease
Adult
Cesarean Section
Colectomy
Colon, Ascending pathology
Colon, Ascending surgery
Digestive System Surgical Procedures
Female
Fetal Death
Gestational Age
Humans
Ileum pathology
Ileum surgery
Jejunum pathology
Jejunum surgery
Mesenteric Ischemia complications
Mesenteric Ischemia pathology
Mesenteric Ischemia surgery
Pregnancy
Pregnancy Complications, Cardiovascular pathology
Pregnancy Complications, Cardiovascular surgery
Pregnancy Trimester, Third
Abdomen, Acute diagnosis
Mesenteric Ischemia diagnosis
Pregnancy Complications, Cardiovascular diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2393
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC pregnancy and childbirth
- Publication Type :
- Academic Journal
- Accession number :
- 30537943
- Full Text :
- https://doi.org/10.1186/s12884-018-2126-1