Ülkü METE URAL, Funda DAĞISTANLI

Gebelikte Nadir Bir Akut Batın Nedeni: İnternal Herniasyon

İnternal herniasyon, intestinal obstrüksiyonunun nadir görülen nedenlerinden biridir. İntestinal obstrüksiyona en sık yol açan nedenler; adeziv bantlar, volvulus ve invajinasyondur. Klinikte sıklıkla görülen klasik triadı, kolik tarzında karın ağrısı, bulantı/kusma ve gaz gayta deşarjının olmamasıdır. Klinik bulguların hepsinin birlikte görülmeyebilmesi, bulguların obstetrik ağrılar ile karışabilmesi ve radyolojik tanı yöntemlerinin uygulanmasına bağlı oluşabilecek olası fetal yan etkiler nedeniyle gebelikte internal herniasyon tanısının konulması oldukça zordur. Yüksek maternal ve fetal mortalite riski nedeniyle erken tanı konulması ve cerrahi müdahale gerekli ise vakit kaybetmeden uygulanması önemlidir. Akut batın ön tanısı ile başvuran tüm gebelerde, intestinal obstrüksiyon ve bu klinik tabloya neden olabilecek internal herniasyon tanısı akılda tutulmalıdır

Anahtar Kelimeler:

gebelik, intestinal obstrüksiyon, internal herniasyon

A Rare Cause of Acute Abdomen in Pregnancy: Internal Herniation

Internal herniation is one of the rare causes of intestinal obstruction. The most common causes of intestinal obstruction are adhesive bridges, volvulus, and invagination. The classic triad frequently seen in the clinic includes colic type abdominal pain, nausea/vomiting and absences of gas passage and defecation. It is very difficult to diagnose internal herniation during pregnancy due to the inability to see all clinical findings together, to confuse the findings with obstetric pain, and to the possible fetal side effects due to the application of radiological diagnostic methods. Because of high maternal and fetal mortality risk, it is important to make an early diagnosis and perform surgical intervention without any delay if necessary. In all pregnant women presenting with a diagnosis of acute abdomen, intestinal obstruction and the possibility of the internal herniation that may cause this clinical picture should be kept in mind

Keywords:

Pregnancy, intestinal obstruction, internal herniation,

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