A RARE CASE OF BOWEL GANGRENE WITH PREGNANCY WITH IUD
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 51
Abstract
PRESENTATION OF CASE A 26 year primigravida was referred with the diagnosis of 28 week pregnancy with intestinal obstruction. She complained of distension, pain in abdomen, not passing stool and flatus since 2 days, vomiting since 1 day. No history of previous surgery. On examination, her condition was poor, pulse 120/min., respiration 44/min. and blood pressure 100/60 mmHg. Abdominal inspection revealed gross distension. On palpation, abdomen was tense, guarding and tenderness was present, no fluid thrill or shifting dullness found, bowel sounds absent. Height of uterus was not clearly marked. Vaginal examination showed foetal head deep in pelvis and cervical os closed and posteriorly placed. Per rectal examination revealed an empty rectum. Investigation- HB 8.7 g%, blood group- O negative, WBC 20.95 x 103 /UL, urine examination positive for blood cells, pus cells 40-50/hpf and RBC 30-40/hpf. USG whole abdomen showed subacute intestinal obstruction with mild ascites. USG obstetrics showed 28 weeks pregnancy with intrauterine dead foetus. X-ray abdomen standing showed multiple free fluid levels suggestive of intestinal obstruction. Fluid resuscitation and intravenous antibiotics were started, nasogastric tube suctioning had large amount of bilious fluid (approximately 1000 mL). Surgical referral suggested subacute intestinal obstruction.
Authors and Affiliations
Jasbir Kaur Saluja, Pulkit Kumar Roy, Vishal Dubey, Monika Aggarwal, Rinku Kushwaha
Keywords
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- EP ID EP220258
- DOI 10.18410/jebmh/2017/626
- Views 70
- Downloads 0
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