Hypercalcemia-Induced Pancreatitis in Pregnancy Following Calcium Carbonate Ingestion

2017 ◽  
Vol 32 (2) ◽  
pp. 225-227 ◽  
Author(s):  
May S. Trezevant ◽  
John C. Winton ◽  
Ashley K. Holmes
Keyword(s):  
Abdominal Pain ◽  
Calcium Carbonate ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Pregnant Patient ◽  
Abdominal Ultrasound ◽  
Laboratory Findings ◽  
Emergency Cesarean ◽  
Intravenous Fluid Administration ◽  
In Pregnancy

Background: Calcium carbonate is often used to relieve Gastroesophageal Reflux Disease (GERD) in pregnant patients. This report describes a potentially serious complication. Case: A pregnant female presented at 34 weeks gestation with abdominal pain, nausea, and vomiting. Home medications included an unquantifiable amount of calcium carbonate 500 mg due to constant consumption for GERD. Laboratory findings included elevated calcium, amylase, lipase, and triglyceride level. Pancreatitis was diagnosed and abdominal ultrasound excluded gallstones. Despite hydration, lipase rose and emergency cesarean section was performed. Hypercalcemia was managed by intravenous fluid administration. After delivery, pancreatitis resolved. Conclusion: Pancreatitis developed in pregnant patient with hypercalcemia due to excessive calcium carbonate ingestion and resolved after delivery of the fetus, fluid resuscitation, and return of calcium level to normal.

scholarly journals Intestinal obstruction due to small bowel herniation through foramen of Winslow: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
P. K. B. S. C. Bandara ◽  
A. M. Viraj Rohana ◽  
Aloka Pathirana
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Intestinal Obstruction ◽  
Reflux Disease ◽  
Bowel Loop ◽  
Internal Herniation ◽  
Small Bowel Loop ◽  
Foramen Of Winslow

Abstract Background Intestinal obstruction due to internal herniation of the bowel is a rare clinical entity which is often overlooked in the differential diagnosis of patients with abdominal pain who have no previous history of abdominal surgery. Several sites of bowel internal herniation have been described, amongst which internal herniation through the foramen of Winslow accounts for about 8% of cases. These patients present with nonspecific abdominal pain associated with symptoms of gastroesophageal reflux disease, and hence the diagnosis is often overlooked. The usual symptoms of intestinal obstruction can be delayed, which results in a delay in diagnosis and gangrene of the herniated bowel segment. Abdominal radiographs and computed tomography are helpful in the diagnosis. Open reduction is the management of choice; however, laparoscopic reduction has also been attempted, with good results. Case presentation We report a case of a middle-aged Sri Lankan man who presented with features of gastroesophageal reflux disease, developed features of intestinal obstruction and was found to have a gangrenous small bowel loop which had herniated through the foramen of Winslow. Following needle aspiration and reduction of the herniated small bowel loop, the gangrenous part of the small bowel was resected and an ileoileal anastomosis performed. The large foramen of Winslow was partially closed with interrupted stitches. The patient made an uneventful recovery. Conclusion Since delayed diagnosis of bowel obstruction is detrimental, it is of utmost importance to diagnose it early. Because internal herniation of the small bowel through the foramen of Winslow presents with nonspecific symptoms including features of gastroesophageal reflux disease, as documented in several cases worldwide and also presented by our patient, there should be a high degree of suspicion of internal herniation of the bowel causing bowel obstruction and low threshold for extensive investigation of patients presenting with symptoms of gastroesophageal reflux disease which does not resolve with usual medication.

The Pregnant Surgical Patient

2015 ◽  
Author(s):  
Nina Tamirisa ◽  
Sami Kilic ◽  
Mostafa Borahay
Keyword(s):  
Critical Care ◽  
Abdominal Pain ◽  
Imaging Modality ◽  
Pregnant Patient ◽  
Surgical Patient ◽  
Changes In Pregnancy ◽  
Surgical Conditions ◽  
Laboratory Changes ◽  
In Pregnancy

The most vulnerable time for a fetus is during embryogenesis in the first 8 to 10 weeks of pregnancy, when women may be unaware of their pregnancy. Once pregnancy is established, a standard approach to the pregnant patient is the optimal way to ensure medical and surgical decisions are made within the context of maintaining the safety of both mother and fetus. This review describes the approach to the pregnant patient for surgical conditions within the context of physiologic changes of the patient and fetus at each trimester, anesthesia and critical care in pregnancy, imaging and drugs safe for use in pregnancy, and nongynecologic surgery in the pregnant patient and specific surgical conditions. Tables outline the classification of abortion, the assessment of pregnancy viability, physiologic changes in pregnancy, laboratory changes in pregnancy, imaging modality and radiation dose, and antibiotics and safety in pregnancy. Figures include a diagram of types of hysterectomy, respiratory changes in pregnancy, and enlargement of the uterus. Algorithms outline the approach to abdominal pain in the pregnant patient and diagnosis and management of ectopic pregnancy. This review contains 5 figures, 6 tables, and 85 references.

scholarly journals Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Balvinder Sagoo ◽  
Ka Ying Bonnie Ng ◽  
G. Ghaleb ◽  
Heather Brown
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Ferrous Sulphate ◽  
Abdominal Ultrasound ◽  
Large Mass ◽  
General Anesthetic ◽  
Risk Pregnancy ◽  
Emergency Cesarean ◽  
First Case ◽  
Spontaneous Expulsion

We present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG. A live infant was delivered by an emergency cesarean section. Five weeks postpartum, she presented with abdominal pain, offensive vaginal discharge, and fevers. She was given antibiotics and ferrous sulphate. An abdominal ultrasound showed an 11 × 12 × 9 cm fibroid with a coarse degenerative appearance. Clinically, she showed signs of sepsis; a CT scan and laparotomy performed under general anesthetic did not find any collections as a source of sepsis. When stable, she was discharged. She re-presented two days later with a large mass (necrotic fibroid) in her vagina. This is the first case of spontaneous expulsion of fibroid six weeks after caesarean section. Presentation of pain and fever after the delivery may be due to red degeneration of the fibroid, caused by diminished blood supply, ischaemia, and necrosis. This case highlights the importance of considering fibroids as a cause for abdominal pain during and after pregnancy, even up to 6 weeks after delivery.

Spontaneous hematoma of the rectus abdominal wall in pregnancy

2013 ◽  
Vol 2 (1-2) ◽  
Author(s):  
Mihaela Grigore ◽  
Camelia Cojocaru ◽  
Alina Mares
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Ovarian Tumor ◽  
Rectus Sheath ◽  
Pregnant Patient ◽  
Rare Entity ◽  
Resonance Imaging ◽  
Rectus Sheath Hematoma ◽  
Spontaneous Hematoma ◽  
In Pregnancy

AbstractRectus sheath hematoma is an uncommon and often clinically misdiagnosed cause of abdominal pain. We report such a case of a 42-year-old woman who developed an abdominal-wall hematoma at 32 weeks of gestation. Initially, she was suspected as having a complicated ovarian tumor associated with pregnancy, because of the intense abdominal pain. Both ultrasound and magnetic resonance imaging proved to be useful in diagnosing rectus sheath hematoma. A conservative management was applied for the rectus sheath hematoma and the patient recovered uneventfully. Although it is a very rare entity, rectus sheath hematoma should be included in the differential diagnosis of every pregnant patient who presents with abdominal pain.

scholarly journals Acute gangrenous appendicitis and acute gangrenous cholecystitis in a pregnant patient, a difficult diagnosis: a case report

2021 ◽  
Vol 8 (5) ◽  
pp. 1575
Author(s):  
David Lew ◽  
Jane Tian ◽  
Martine A. Louis ◽  
Darshak Shah
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
General Population ◽  
Acute Appendicitis ◽  
Acute Cholecystitis ◽  
Pregnant Patient ◽  
Anatomical Changes ◽  
Difficult Diagnosis ◽  
Common Complaint ◽  
In Pregnancy

Abdominal pain is a common complaint in pregnancy, especially given the physiological and anatomical changes that occur as the pregnancy progresses. The diagnosis and treatment of common surgical pathologies can therefore be difficult and limited by the special considerations for the fetus. While uncommon in the general population, concurrent or subsequent disease processes should be considered in the pregnant patient. We present the case of a 36 year old, 13 weeks pregnant female who presented with both acute appendicitis and acute cholecystitis.

scholarly journals Late diagnosis of pheochromocytoma in pregnancy with poor fetal outcome

2021 ◽  
Vol 27 (1) ◽  
pp. 9-11 ◽  
Author(s):  
Gauri Bapayeva ◽  
Milan Terzic ◽  
Karlygash Togyzbayeva ◽  
Aigerim Bekenova ◽  
Sanja Terzic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Fetal Lung ◽  
Abdominal Ultrasound ◽  
First Trimester ◽  
Maternal Blood ◽  
Fetal Outcome ◽  
Hypertensive Disorder ◽  
Emergency Cesarean ◽  
In Pregnancy

Pheochromocytomas are rare tumors producing catecholamines that could be a cause of secondary hypertension. On that basis, pheochromocytoma can occur as an extremely rare cause of hypertension in pregnancy and if diagnosed late can lead to adverse maternal-fetal outcome. In this case report we describe a case of pheochromocytoma affected pregnancy with poor fetal outcome. A 27-year-old pregnant woman was admitted for severe pre-eclampsia due to pre-gestational hypertension that was diagnosed during the first trimester. Due to high and uncontrolled maternal blood pressure and the worsened maternal-fetal condition after the admission induction of fetal lung maturity and emergency cesarean section were performed, but with poor fetal outcome. Later, an adrenal gland mass was identified using abdominal ultrasound and confirmed by computed tomography. After surgical adrenalectomy blood pressure of the patient was normalized. Pheochromocytoma should be considered as a possible cause of hypertensive disorder during pregnancy, particularly in cases of severe and unresponsive hypertension in order to provide for timely and appropriate treatment.

Management of ureteric stones in pregnancy

2017 ◽  
Author(s):  
Ben Turney ◽  
John Reynard
Keyword(s):  
Abdominal Pain ◽  
Renal Colic ◽  
Treatment Options ◽  
Pregnant Patient ◽  
Stone Extraction ◽  
Surgical Technology ◽  
Recommended Treatment ◽  
Potential Problems ◽  
Primary Management ◽  
In Pregnancy

Renal colic is the most common non-obstetric cause for abdominal pain and hospitalization during pregnancy. Ureteric stones occur in about 1 in 2,000 pregnancies, most (>80%) in the second and third trimesters. Primary management concerns are diagnostic foetal radiation exposure and the potential for adverse perinatal events arising either from the stone or from intervention. Indications for intervention are the same as for the non-pregnant patient, but are influenced by obstetric circumstances. Active treatment options may be temporizing (stent or nephrostomy) or definitive (ureteroscopic stone extraction). Historically, temporizing measures were the only recommended treatment option. However, potential problems associated with temporary drainage mechanisms include recurrent obstruction, infection, nephrostomy displacement, encrustation, infection, and pain. These factors may impact on pregnancy. In recent years, advances in surgical technology and technique have permitted definitive ureteroscopic management of stones during pregnancy.

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