2011, Number 02
<< Back Next >>
Ginecol Obstet Mex 2011; 79 (02)
Cesárea por colitis ulcerosa crónica inespecífica
Unda-Franco E, Ramírez-Avilés EM, Moreno-de Gante L, Héctor-González Q
Language: Spanish
References: 10
Page: 93-96
PDF size: 284.68 Kb.
ABSTRACT
We present a case of a 35 year old patient with diagnosis of ulcerative colitis that presented failure and complications associated with medical treatment; with a report of a colonoscopy and biopsy of pancolitis with severe activity. The patient was submitted to laparoscopic restorative total proctocolectomy with ileal “J” pouch anal anastomosis. Two months later the ileostomy was reversed.The patient received progesterone at the same time she was receiving immunosuppressive drugs. This was suspended two months after the second colon surgery. The patient did not require treatment with ovulation induction to achieve pregnancy. At the fourth month of gestation, thepatient developed a perianal abscess, which was successfully drained. After multidisciplinary assessment in week 38 of gestation, it was decided to perform cesarean birth as a way to not affect the ileal pouch and the anastomosis of the digestive tract. At present time, the patient has had no further complications.
REFERENCES
Vargas-de la Llata RG. Tratado de Cirugía General. México: Manual Moderno: Consejo Mexicano de Cirugía General, 2003;pp:817-820.
Aouthmany A, Horattas M. Ileal Pouch Perforation in Pregnancy: Report of a Case and Review of the Literature. Dis Colon Rectum 2004;47(2):243-245.
Kane S, et al. Higher incidence of abnormal Pap smears in women with inflammatory bowel disease. Am J Gastroenterol 2008;103(4):1046-1057.
Gorgun E, Remzi FH, Goldberg JM, et al. Fertility is reduced after restorative proctocolectomy with ileal pouch-anal anastomosis: a study of 300 patients. Surgery 2004;136:795–803.
Lopez-Rosales F, Gonzalez-Contreras Q, Muro LJ, et al. Laparoscopic total proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis: initial experience in Mexico. Surg Endosc 2007;21(12):2304- 2307.
Remzi FH, Gorgun E, Bast J. Vaginal Delivery After Ileal Pouch- Anal Anastomosis: A Word of Caution. Dis Colon Rectum 2005;48:1691–1699.
Ravid et. al. Pregnancy, Delivery, and Pouch Function After Ileal Pouch-Anal Anastomosis for Ulcerative Colitis Dis Colon Rectum 2002;45:1283–1288.
Snooks SJ, Setchell M, Swash M, Henry MM. Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet 1984;2:546–50.
Cima RR, et al. ACS Surgery: Principles and Practice;2007:33.
Mahadevan U. Pregnancy and inflammatory Bowel Disease. Med Clin N Am 2010;94:53-73.