Presentation
Upper abdominal pain in a 32-week pregnant woman.
Patient Data
Large amount of free fluid in left paracolic gutter and between intestinal loops.
Arterial phase (not shown) and late venous phase CT:
Gravid uterus, advanced pregnancy.
Case Discussion
The woman was rushed to the OR for exploratory laparotomy. The surgical report was as follows: "Intussusception of a long segment of jejunum, at least 50 cm in length. Following its release, an ischaemic segment was revealed with a haemorrhagic wall and abscence of pulse. In addition, a large 3-cm polyp was palpated in the proximal bowel. Moderate amount of serotic fluid in the abdominal cavity. Proximal small bowel markedly dilated, up to 5-6 cm. [...] 70 cm of jejunum excised. End-to-end anastomosis. [...] Small incision over jejunal polyp and excision of polyp with long stalk."
As bowel ischaemia requires emergent surgery, abdominal CT can be justified in pregnancy. Of note, the hospital did not have an MRI machine at the time.
Unable to process the form. Check for errors and try again.