-
Review
-
Korean J Med. 2006;71(1):256-256.
- A case of intestinal malrotation manifested during pregnancy
-
임종필&#;강정묵&#;양종인&#;우상명&#;이재경&#;김지원&#;김병관&#;이국래
-
.
- A case of intestinal malrotation manifested during pregnancy
-
-
1Department of Internal Medicine, Hanyang University College of Medicine, Seoul; 2Department of Life Science, Postech Biotech Center, Pohang University of Science and Technology, Pohang, Korea
-
- Abstract
- Intestinal malrotation is defined as an anomaly of fetal intestinal rotation which occurs most commonly in the first month of life.
It is uncommon for malrotation to present in adolescents and adults, and symptomatic patients present with either acutely bowel
obstruction and intestinal ischemia, or chronically vague abdominal pain. Moreover, the diagnosis of intestinal malrotaion during
pregnancy poses special problems, because vomiting can be attributed to hyperemesis gravidarum and radiological investigations
are avoided during pregnancy. Herein, we present a case of intestinal malrotation manifested during pregnancy. A 30-year-old
woman in her 17th week of pregnanacy was referred to our hospital because of recurrent nausea and vomiting. No diagnostic
abnormality except elevated AST/ALT was found and she was discharged with resolved nausea and vomiting after conservative
management. However, she was readmitted with recurrence of symptoms and weight loss. Nausea and vomiting continued
despite of conservative management and fetal loss occurred on 25th week of pregnancy. Radiological examination including
abdominal CT and UGI study was done after fetal loss. UGI study and abdominal CT showed distended stomach and duodenum
with Z-shaped course and beaked appearance of distal duodenum, and that thick-walled small bowel loops were noted on the
right. She received duodenojejunostomy and operative finding showed that small intestine with SMA and SMV passed under the
ascending colon. Vomiting was subsided and oral intake was possible after surgical correction and she was discharged
uneventfully.
Keywords :
