Intussusception: a rare cause of abdominal pain in pregnancy.
A 34-year-old woman presented at 19 weeks in her third pregnancy with abdominal pain and hyperemesis. This was her third admission during the pregnancy for similar complaints. A few days after admission an exacerbation in her pain was noted, in particular on eating or lying down, and a firm and mobile epigastric mass could be palpated separate from her uterus. The differential diagnosis was a hernia or a degenerating pedunculated fibroid. Sonography revealed a mass separate from the uterus with an appearance consistent with intussusception. Magnetic resonance imaging confirmed the diagnosis. A limited right hemicolectomy was performed. The final diagnosis was adenocarcinoma of the colon. It is difficult to diagnose intussusception during pregnancy. The presenting symptoms of nausea, vomiting, abdominal pain and constipation are common in pregnancy and the displacement of the bowel by the gravid uterus hampers examination. Intussusception is very rare in adults and generally it is associated with tumors. Preoperative diagnosis is difficult but possible with accurate imaging.
Penney
D
D
Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK.
Ganapathy
R
R
Jonas-Obichere
M
M
El-Refeay
H
H
D015746:Abdominal Pain / Q000209:etiology*; D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis; D000328:Adult; D003110:Colonic Neoplasms / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007443:Intussusception / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis*; D016216:Ultrasonography, Prenatal