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Duodenal Obstruction During Pregnancy Publisher



Haghiri M1 ; Borna S1 ; Hessami K2, 3 ; Sharifi A4 ; Tafti SMA5 ; Malek M6 ; Pourdamghan N7 ; Hantoushzadeh S1 ; Shirdel Abdolmaleki A8 ; Saleh M1
Authors
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Authors Affiliations
  1. 1. Maternal Fetal and Neonatal Research Center, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States
  3. 3. Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4. Department of Surgery, Beesat Hospital, Hamadan University of Medical Sciences, Tehran, Iran
  5. 5. Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Radiology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Tehran, Iran
  8. 8. School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Source: Case Reports in Obstetrics and Gynecology Published:2022


Abstract

Intractable vomiting and elevated liver enzymes during pregnancy seem to be associated to the obstetric etiologies; however, other causes such as acute surgical emergencies should be considered. The patient was a 26-year-old woman at 18 weeks of gestation with intractable vomiting, intolerability of oral intake, weight loss, and absence of abdominal pain. Her physical examinations and laboratory tests had no remarkable findings except elevated liver function test (LFT) and hypokalemia. Considering the lab data and normal abdominopelvic ultrasound, magnetic resonance imaging was performed which revealed dilation of the D1-3 and collapse the D4 sections of duodenum. She underwent exploratory laparotomy which confirmed duodenal obstruction caused by Ladd's band. After the Ladd's operation, the patient started oral intake of nutritious, and her LFT decreased to normal ranges. After the last follow-up, she has had gained 18 kg and gave birth at 36 weeks of gestation due to the premature rapture of membranes and delivered a 2 kg small for gestational age otherwise healthy infant. The experience gained from this case was to consider all possibilities (such as small bowel obstruction) and evaluate them in a pregnant patient to consider other causes of nausea, vomiting, and abnormal LFTs in a pregnant patient. © 2022 Mansooreh Haghiri et al.