Abstract
Acute abdomen in pregnancy continues to be one of the most challenging diagnosis and treatment dilemmas today. Abdominal pain can develop due to intra-abdominal organs as well as obstetric causes. In pregnancy, the myoma can degenerate, cause myometrium to become torsion, or it can cause pain by causing massive torsion of the uterus. In this case report, it is discussed the difficulty of differentiating abdominal pain from an old cesarean section with an obstetric emergency or a surgical emergency. A 38-year-old patient with recurrent cesarean section with G3 P2 presented with abdominal pain during pregnancy week. There was widespread sensitivity to physical examination. Both ovaries were normal with ultrasonography. Cesarean was applied with the preliminary diagnosis of plecanta decollement. Intraoperative observation revealed that the uterus was subserosal myomatous torsion with a fine pedicle near the right coronal surface. The patient underwent myomectomy during cesarean section.
Keywords
References
- 1. Öztürk, H. B., Selam, B., Demirel, C., Ergin, T., & Lembet, A. Gebelikte Akut Karın Nedeni Olarak Miyom Torsiyonu. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi; 1(1) :2010: 54-56 2. Gezginç K., Dalkılıç EU. Obstetrik Acillere Yaklaşım. JAEM 2011; 10: 128-32 3. Augustin G, Majerovic M. Non obstetrical acute abdomen during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007; 131(1): 4-12 4. Kennedy A. Assessment of acute abdominal pain in the pregnant patient. Semin Ultrasound CT MR 2000; 21: 64-77 5. Birchard KR, Brown MA, Hyslop WB, Firat Z, Semelka RC. MRI of acute abdominal and pelvic pain in pregnant patients. AJR Am J Roentgenol 2005; 184(2): 452-458 6. Exacoustòs C, Rosati P. Ultrasound diagnosis of uterine myomas and complications in pregnancy. Obstet Gynecol 1993; 82(1): 97-101 7. Tsai Y-J, Yeat S-K, Jeng C-J, Chen S-C. Torsion of a uterine leiomyoma. Taiwanese J Obstet Gynecol 2006; 45(4) 8. Mickel I, Bollmann R, Chaoui R, Lau HU. Torsion of the myoma pedicle as a rare cause of ileus in puerperium. Geburtshilfe Frauenheilkd. 1995; 55(12): 721-723
Abstract
Gebelikte
akut karın bugün en zorlu tanı ve tedavi ikilemlerinden biri olmaya devam
etmektedir. Karın ağrısı
obstetrik nedenlerle olabileceği kadar karın içi organlar nedeniyle de
gelişebilmektedir. Gebelikte miyom
dejenere olarak, saplı miyomun torsiyone olmasıyla veya kitle etkisine bağlı
uterusun torsiyonuna yol açarak ağrıya yol açabilir.
Bu
olgu sunumunda eski sezaryenlı gebede gelişen karın ağrısının obstetrik bir acil mi yoksa cerrahi bir acil
mi ayrımı yapılmasının zorluğu tartışılmıştır. Mukerrer sezaryenli G3 P2 olan 38
yaşında hasta, gebelik haftasında karın ağrısı ile başvurdu. Fizik muayenede
batında yaygın hassasiyet mevcuttu. Ultrasonografi de her iki over normal
olarak değerlendirildi. Plesanta dekolmanı ön tanısı ile sezaryen uygulandı. İntraoperatif
gözlemde uterus sağ kornual yüze yakın ince pediküllü subserozal miyomun
torsiyone olduğu tespit edildi. Hastaya sezaryen sırasında miyomektomi
uygulandı.
Keywords
References
- 1. Öztürk, H. B., Selam, B., Demirel, C., Ergin, T., & Lembet, A. Gebelikte Akut Karın Nedeni Olarak Miyom Torsiyonu. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi; 1(1) :2010: 54-56 2. Gezginç K., Dalkılıç EU. Obstetrik Acillere Yaklaşım. JAEM 2011; 10: 128-32 3. Augustin G, Majerovic M. Non obstetrical acute abdomen during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007; 131(1): 4-12 4. Kennedy A. Assessment of acute abdominal pain in the pregnant patient. Semin Ultrasound CT MR 2000; 21: 64-77 5. Birchard KR, Brown MA, Hyslop WB, Firat Z, Semelka RC. MRI of acute abdominal and pelvic pain in pregnant patients. AJR Am J Roentgenol 2005; 184(2): 452-458 6. Exacoustòs C, Rosati P. Ultrasound diagnosis of uterine myomas and complications in pregnancy. Obstet Gynecol 1993; 82(1): 97-101 7. Tsai Y-J, Yeat S-K, Jeng C-J, Chen S-C. Torsion of a uterine leiomyoma. Taiwanese J Obstet Gynecol 2006; 45(4) 8. Mickel I, Bollmann R, Chaoui R, Lau HU. Torsion of the myoma pedicle as a rare cause of ileus in puerperium. Geburtshilfe Frauenheilkd. 1995; 55(12): 721-723
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 30, 2018 |
| Published in Issue | Year 2018 Volume: 1 Issue: 2 |
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