CMV infection in a pregnant woman complicated by toxic megacolon and mesenteric vein thrombosis

Zamani, Farhad; Amiri, Ali; Mohit, Mohamad; Zolfaghari, Mohamadali; Jalaeefar, Amirmohsen; Ranjbar, Mahdy; Shakeri, Ramin

doi:10.4318/tjg.2009.0016

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…One patient received IVF-ET treatment (18). Pregnancy was accompanied by mesocolic and infectious pathologies in the remaining 3 patients (19)(20)(21). Surgical treatment was applied to 14 of 17 patients in the literature.…”

Section: Resultsmentioning

confidence: 99%

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Acute mesenteric thrombosis in a pregnant woman with Factor V Leiden mutation with a history of in vitro fertilization and embryo transfer: case report and literature review

Karahan

Atay

Dılek

et al. 2022

Rev. Colomb. Obstet. Ginecol.

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Objectives: To report the case of a patient diagnosed with acute mesenteric vein thrombosis (AMVT) associated with Factor V Leiden mutation and a history of in vitro fertilization and embryo transfer and review the literature on risk factors and treatments performed for AMVT. Materials and methods: We reported the case of a 37-year-old pregnant woman. A bibliographic search was carried out in Medline/PubMed and LILACS, filtering by type of language (English and Spanish). Primary cohort studies, cases and controls, case reports and case series were included, which addressed the risk factors associated with the development of acute mesenteric thrombosis during pregnancy and treatments performed. Results: The search identified cases and control studies, case reports and case series related to mesenteric ischemia, pregnancy and in vitro fertilization. The literature reported that the main factors associated with mesenteric ischemia are pregnancy itself, genetic factors, drugs, protein C and protein S deficiency and idiopathic causes. Conclusions: SMV thrombosis is a life-threatening and very rarely seen condition that emerges in pregnancies. The literature suggests that, during gestation, the factors associated with the development of acute mesenteric thrombosis are hypercoagulability induced by pregnancy, the administration of oral estrogen during IVF-ET, and other precipitating factors. More studies are required to better understand the possible additional factors and build better optimal treatment algorithms.

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Section: Resultsmentioning

confidence: 99%

“…One patient had normal labor with small bowel resection and anastomosis 10 . Sigmoid colon resection and Hartman colostomy were performed on 2 patients 9 , 21 . Diagnostic laparotomy was applied to 1 patient, and then labor was normal 19 .…”

Section: Resultsmentioning

confidence: 99%

Acute mesenteric thrombosis in a pregnant woman with Factor V Leiden mutation with a history of in vitro fertilization and embryo transfer: case report and literature review

Karahan

Atay

Dılek

et al. 2022

Rev. Colomb. Obstet. Ginecol.

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“…As shown in Table 1, four of these affected pregnant women had a documented inherited thrombophilia, including factor V Leiden gene mutation [12], protein S deficiency [13, 14] and antithrombin deficiency [15]. One woman developed MVT following impregnation via IVF-ET [9], one had mistakenly used oral contraceptive pill and smoked heavily [16, 17], two had surgical emergencies including mid-gut volvulus [18] and a mesenteric cyst [19], one had cytomegalovirus (CMV) infection [20], one had a history of chronic idiopathic MVT [21] and the other four cases had no documented additional risk factors for MVT [10, 11, 22, 23]. Although in our reported case, antithrombin III activity was mildly decreased at a single time point during the patient’s second pregnancy, it returned to normal a month later without any medication.…”

Section: Discussionmentioning

confidence: 99%

Acute mesenteric venous thrombosis in a pregnant woman at 35 weeks of gestation: a case report and review of the literature

Guan

Huang

2018

BMC Pregnancy Childbirth

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BackgroundMesenteric venous thrombosis (MVT) is an infrequent thrombotic event that can cause devastating intestinal hemorrhagic ischemia. The mortality rate among patients with acute MVT ranges from 20 to 50%. Occurrence of MVT in pregnancy is quite rare. In this case report, we describe a pregnant woman who presented with acute MVT at 35 weeks of gestation.Case presentationOur case was a 26-year-old primigravid woman at 35 weeks gestation. She presented to Guangzhou First People’s Hospital with complaints of abdominal pain, nausea and vomiting. The second day after admission, she complained of more intense abdominal pain, anorexia, vomiting and abdominal distention that were out of proportion to physical signs. An emergency exploratory laparotomy was performed. The entire ileum, part of the jejunum and part of the ascending colon were gangrenous, and thromboembolism was discovered in the corresponding mesenteric veins. The necrotic intestine was resected and an end-to-end jejunum-colon anastomosis was performed. A cesarean section was performed to remove the placenta and fetus, which had expired. Histopathological analysis revealed extensive edema, hemorrhage, inflammatory infiltration and necrosis in the resected bowel, and widespread thrombosis in mesenteric venous lumens.ConclusionThe diagnosis of MVT during pregnancy is very difficult due to its low incidence, and non-characteristic symptoms, signs and laboratory results. MVT may be the underlying cause of severe abdominal pain during pregnancy and should be included in the differential diagnosis of pregnant patients with an acute abdomen.

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“…Precipitating factors associated with MVT may include portal hypertension, postoperative state, trauma, neoplasm, inflammatory bowel diseases, use of estrogen-containing compounds, polycythemia vera, hemoglobinopathies, and hypercoagulable states resulting from protein S, protein C, and antithrombin III deficiencies [17]. Through the literature review, additional precipitating factors could be identified in 8 of the 9 pregnant women with small bowel ischemia due to superior MVT: 2 had mistakenly used oral pills during pregnancy [8, 9], 2 had known history of hypercoagulopathies [10, 11], 1 developed MVT soon after elective cesarean section [12], 1 had CMV infection complicated further by toxic megacolon [13], 1 had history of chronic idiopathic MVT [14], and 1 had hemoglobinopathy [15]. Only one case in the literature and our case possess no precipitating factor to develop MVT [16].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Superior Mesenteric Vein Thrombosis Resulting in Small Bowel Ischemia in a Pregnant Woman

Lin

Huang

2011

Case Reports in Obstetrics and Gynecology

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Background. Small bowel ischemia due to superior mesenteric vein thrombosis (MVT) is rare during pregnancy. However, additional precipitating factors should usually be identified. Case. A 31-year-old woman, pregnant at 34 weeks, was sent to the emergency department because of acute peritonitis. An emergency exploration revealed a segmental gangrene of the small intestine without any mechanical obstruction. Together with the termination of pregnancy, resection of the damaged small bowel was performed, and an end-to-end enterostomy was followed. Based on the operative and pathological findings, small bowel ischemia might be attributed to superior mesenteric vein thrombosis. Conclusion. Hypercoagulation state normally found in pregnant women is believed to lead to this catastrophic condition without other precipitating factors.

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CMV infection in a pregnant woman complicated by toxic megacolon and mesenteric vein thrombosis

Cited by 8 publications

References 6 publications

Acute mesenteric thrombosis in a pregnant woman with Factor V Leiden mutation with a history of in vitro fertilization and embryo transfer: case report and literature review

Acute mesenteric thrombosis in a pregnant woman with Factor V Leiden mutation with a history of in vitro fertilization and embryo transfer: case report and literature review

Acute mesenteric venous thrombosis in a pregnant woman at 35 weeks of gestation: a case report and review of the literature

Idiopathic Superior Mesenteric Vein Thrombosis Resulting in Small Bowel Ischemia in a Pregnant Woman

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