caa a22 4500 445307447 CHVBK 20180317142617.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s00404-010-1789-2 doi (NATIONALLICENCE)springer-10.1007/s00404-010-1789-2 Mid-gut volvulus and mesenteric vessel thrombosis in pregnancy: case report and literature review [Elektronische Daten] [Losa Shui, Junaid Rafi, Allan Corder, David Mowbray] Background: Mid-gut volvulus is a rare complication of pregnancy, where torsion of the small bowel around its mesentery can result in extensive bowel infarction. To our knowledge, there has been no previous reported case of mid-gut volvulus and mesenteric vessel thrombosis managed without bowel resection. Case: A 25-year-old woman presented at 35+3weeks gestation with constant abdominal pain. There was no past medical history of abdominal surgery. The patient later developed feculent vomiting. Exploratory laparotomy revealed a mid-gut volvulus causing small bowel ischaemia, which extended from the duodenojejunal (DJ) flexure to the terminal ileum. There was also mesenteric arterial and venous thrombosis. A healthy baby girl was delivered by caesarean section and the mid-gut volvulus was reduced. Further, two re-look laparotomies confirmed viable bowel following detorsion. The mesenteric vessel thrombosis was treated with intravenous heparin. The patient went on to make a full recovery. Conclusions: As shown in this case, the volvulus and mesenteric vessel thrombosis may occur during pregnancy even in patients without previous history of coagulopathies and abdominal surgery. It is difficult to make a clinical diagnosis, as the symptoms, physical signs and laboratory findings can be misleading. Therefore, a high index of suspicion is necessary for the early diagnosis of these conditions, as prompt treatment can prevent bowel resection and improve maternal and foetal outcomes. Springer-Verlag, 2010 Mid-gut volvulus nationallicence Gestational intestinal obstruction nationallicence Mesenteric vessel thrombosis nationallicence Pregnancy nationallicence Shui Losa Department of Obstetrics and Gynaecology, Hereford County Hospital, HR1 2ER, Hereford, UK aut Rafi Junaid Department of Obstetrics and Gynaecology, Hereford County Hospital, HR1 2ER, Hereford, UK aut Corder Allan Department of General Surgery, Hereford County Hospital, Hereford, UK aut Mowbray David Department of Obstetrics and Gynaecology, Hereford County Hospital, HR1 2ER, Hereford, UK aut Archives of Gynecology and Obstetrics Springer-Verlag 283(2011-03-01), 39-43 0932-0067 283<39 2011 283 404 https://doi.org/10.1007/s00404-010-1789-2 text/html Onlinezugriff via DOI 1 brief-communication jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1789-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shui Losa Department of Obstetrics and Gynaecology, Hereford County Hospital, HR1 2ER, Hereford, UK aut NATIONALLICENCE 700 1- Rafi Junaid Department of Obstetrics and Gynaecology, Hereford County Hospital, HR1 2ER, Hereford, UK aut NATIONALLICENCE 700 1- Corder Allan Department of General Surgery, Hereford County Hospital, Hereford, UK aut NATIONALLICENCE 700 1- Mowbray David Department of Obstetrics and Gynaecology, Hereford County Hospital, HR1 2ER, Hereford, UK aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 283(2011-03-01), 39-43 0932-0067 283<39 2011 283 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer