Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case report
Abstract Background Acute intestinal obstruction during pregnancy is a rare digestive surgical emergency with significant maternal and fetal mortality. Diagnosis is difficult, often delaying the management. Here, we report an exceptional association of mechanical acute intestinal obstruction due to...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s13256-017-1540-8 |
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| author | Harissou Adamou Ibrahim Amadou Magagi Souleymane Oumarou Garba Oumarou Habou |
| author_facet | Harissou Adamou Ibrahim Amadou Magagi Souleymane Oumarou Garba Oumarou Habou |
| author_sort | Harissou Adamou |
| collection | DOAJ |
| description | Abstract Background Acute intestinal obstruction during pregnancy is a rare digestive surgical emergency with significant maternal and fetal mortality. Diagnosis is difficult, often delaying the management. Here, we report an exceptional association of mechanical acute intestinal obstruction due to compression by previa uterine leiomyoma, and a ruptured ectopic pregnancy. Case presentation This is the case report of a 43-year-old primiparous black woman from a rural area, who was admitted to the surgical emergency department for acute intestinal obstruction. At examination on admittance, our patient had a bad general condition with clinical anemia. She had an occlusive syndrome that had been evolving for 3 days. A physical examination of her abdomen showed a widespread distension with an irregular and polylobed solid mass occupying the whole of the lower-umbilical and hypogastric area. A rectal examination found an empty rectum, and the mass was perceptible in Douglas’s pouch. At the vaginal examination, we found the same mass and a finger holster was clean. The diagnosis of intestinal occlusion by a tumor was retained. The laparotomy revealed a distended intestine, a ruptured right tubal ectopic pregnancy and a polymyomatous uterus. The most massive previa leiomyoma was adhering and compressing the rectal and sigmoidal hinge. A total hysterectomy was performed and histopathological examination of specimens confirmed myoma and ectopic pregnancy. The surgical follow-up was uneventful, and our patient was discharged on postoperative day 12. Conclusions The etiological diagnosis of acute intestinal obstruction during pregnancy is not easy, especially in the context of a low-income country where the means of biological and radiological diagnosis are lacking. A laparotomy is required before diagnosis of acute surgical abdomen and its management will depend on the intraoperative findings and the condition of the patient. |
| first_indexed | 2024-04-13T13:58:30Z |
| format | Article |
| id | doaj.art-39a7009776e14ce2a0abe6eef4ac4c07 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T13:58:30Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-39a7009776e14ce2a0abe6eef4ac4c072022-12-22T02:44:06ZengBMCJournal of Medical Case Reports1752-19472018-01-011211410.1186/s13256-017-1540-8Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case reportHarissou Adamou0Ibrahim Amadou Magagi1Souleymane Oumarou Garba2Oumarou Habou3Department of General Surgery, Faculty of Health Sciences, University of Zinder, National HospitalDepartment of General Surgery, Zinder National HospitalMother-child Center of ZinderDepartment of Pediatric Surgery, Faculty of Health Sciences, University of Zinder, National HospitalAbstract Background Acute intestinal obstruction during pregnancy is a rare digestive surgical emergency with significant maternal and fetal mortality. Diagnosis is difficult, often delaying the management. Here, we report an exceptional association of mechanical acute intestinal obstruction due to compression by previa uterine leiomyoma, and a ruptured ectopic pregnancy. Case presentation This is the case report of a 43-year-old primiparous black woman from a rural area, who was admitted to the surgical emergency department for acute intestinal obstruction. At examination on admittance, our patient had a bad general condition with clinical anemia. She had an occlusive syndrome that had been evolving for 3 days. A physical examination of her abdomen showed a widespread distension with an irregular and polylobed solid mass occupying the whole of the lower-umbilical and hypogastric area. A rectal examination found an empty rectum, and the mass was perceptible in Douglas’s pouch. At the vaginal examination, we found the same mass and a finger holster was clean. The diagnosis of intestinal occlusion by a tumor was retained. The laparotomy revealed a distended intestine, a ruptured right tubal ectopic pregnancy and a polymyomatous uterus. The most massive previa leiomyoma was adhering and compressing the rectal and sigmoidal hinge. A total hysterectomy was performed and histopathological examination of specimens confirmed myoma and ectopic pregnancy. The surgical follow-up was uneventful, and our patient was discharged on postoperative day 12. Conclusions The etiological diagnosis of acute intestinal obstruction during pregnancy is not easy, especially in the context of a low-income country where the means of biological and radiological diagnosis are lacking. A laparotomy is required before diagnosis of acute surgical abdomen and its management will depend on the intraoperative findings and the condition of the patient.http://link.springer.com/article/10.1186/s13256-017-1540-8Acute bowel obstructionEctopic pregnancyCompressive myomaHysterectomy |
| spellingShingle | Harissou Adamou Ibrahim Amadou Magagi Souleymane Oumarou Garba Oumarou Habou Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case report Journal of Medical Case Reports Acute bowel obstruction Ectopic pregnancy Compressive myoma Hysterectomy |
| title | Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case report |
| title_full | Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case report |
| title_fullStr | Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case report |
| title_full_unstemmed | Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case report |
| title_short | Acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy: a case report |
| title_sort | acute intestinal obstruction due to extrinsic compression by previa myoma and ectopic pregnancy a case report |
| topic | Acute bowel obstruction Ectopic pregnancy Compressive myoma Hysterectomy |
| url | http://link.springer.com/article/10.1186/s13256-017-1540-8 |
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