Case Report
Volume 9 Issue 2 - 2020
Acute Abdomen in Pregnancy… Expect the Unexpected
María Cristina Guerrero de León1*, Edmundo Erbey Castelan Maldonado2, Silvia Judith Hernández Martínez3 and San Juana Elizabeth Campos Hinojosa4
1Intensive Care Unit, Gynecology and Obstetrics Hospital UMAE 23, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México
2Chief of Pathology Department, UMAE 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México
3Pathology Department, UMAE 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México
4Hospital Materno Infantil ISSEMyM, Toluca, Estado de México, México
*Corresponding Author: María Cristina Guerrero de León, Intensive Care Unit, Gynecology and Obstetrics Hospital UMAE 23, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México.
Received: December 01, 2019; Published: January 07, 2020




Abstract

Acute abdomen during pregnancy it refers to any serious intra-abdominal condition related or not related to pregnancy that is accompanied by a sudden severe abdominal pain, muscular rigidity, tenderness, nausea, vomiting and other signs and symptoms that can help to guide in the prompt diagnosis. It complicates 1/500 - 635 pregnancies (0.2 - 2.2%) and about 0.5% - 2% of the patients will require surgery for non-obstetric causes. Represents a major challenge for first contact physician due to the anatomical and physiological changes happening during pregnancy. The wide range of causes and varied spectrum of clinical presentations besides the anatomical and physiological changes in ¨normal pregnancy¨ pose a formidable diagnostic and therapeutic challenge. It is of paramount importance a detailed clinical history and physical examination besides blood samples for laboratory testing and specific investigations. If the patient is hemodynamically unstable it might require urgent laparotomy. In this case a multidisciplinary approach and prompt diagnosis and definite treatment can make the difference between life and death.

We present a clinical case of a 30 year old gravida 2, abortion 1, 19 weeks of pregnancy who arrived to our emergency department with severe acute abdominal pain, palpable mass in left flank, nausea, vomiting and imminent signs and symptoms of hypovolemic shock. Her final diagnosis, outcome of the product and evolution showed us the importance of a detailed clinical history, physical examination and radiological evaluation. A review of literature in the topic was performed and we found that the cause of acute abdomen in our patient was not considered in the diagnostic approach of abdominal pain. The reason might be that the incidence of this condition is very rare. We present a review of abdominal pain in pregnancy and pinpoint the importance of making a complete clinical history, examination of the patient, diagnostic approach and treatment, besides we make a review of the cause of abdominal pain in our patient.

Keywords: Acute Abdomen; Pregnancy; Abdominal Pain; Abdominal Mass; Hypovolemic Shock; Wunderlich Syndrome; Beck Triad; Renal Angiomyolipoma

References

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Citation: María Cristina Guerrero de León., et al. “Acute Abdomen in Pregnancy… Expect the Unexpected”. EC Gynaecology 9.2 (2020): 01-10.

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