Pregnant woman suffers from severe acute pancreatitis, multidisciplinary team joins forces to reverse life crisis

The postoperative physician observed the patient’s condition.

Red Net Moment News, August 4th (Correspondent Peng Yi) Recently, Hu Guohuang, vice president of the General Surgery Department of the Fourth Hospital of Changsha (hepatobiliary, spleen, pancreas, breast and breast surgery), and Elites from obstetrics, neonatology, critical care medicine, anesthesia surgery, emergency department and other departments gathered in the ward.

Everyone frowned, and the patient’s condition was extremely dangerous.

This is a pregnant woman who is more than 32 weeks pregnant. Just the day before, Ms. Xiao, a pregnant woman, felt that the food cooked by her mother was delicious, and she ate twice as much food in one go. Early the next morning, Ms. Xiao, who felt a dull pain in her upper abdomen, didn’t care. She went to a nearby powder shop for breakfast as usual, and then the abdominal pain was unbearable. She hurriedly called 120 and sent it to the emergency center of Changsha Fourth Hospital for emergency treatment.

After relevant examinations by the emergency physician, it was determined that Ms. Xiao was suffering from severe acute pancreatitis at this time. This is a disease with a high mortality rate, and the patient is a pregnant woman, which can easily cause damage to multifunctional organs, which seriously threatens the safety of pregnant women and fetuses. This means that a slight error or even a slight delay may endanger the lives of mother and child. The green channel was opened immediately, and the multidisciplinary consultation started quickly.

Considering that the patient’s gestational week is still young and the fetal heart rate is still stable, after communicating and coordinating with the family, the multidisciplinary experts decided to treat conservatively first, and at the same time promote fetal lung maturation, try to do as much as possible under the premise of the pregnant woman’s condition. Extend the gestational age and reduce the incidence of neonatal complications. At the same time, closely monitor the vital signs of pregnant women and fetuses, and be ready to adjust the treatment plan at any time.

However, everyone’s heart is still hanging high, and Ms. Xiao’s situation is developing in a direction that everyone does not want to see. Ms. Xiao’s condition has not improved significantly, the abdominal pain persists, and the fetal heart rate has also changed. She may die in the womb at any time, and the mother and baby are at stake.

Hu Guohuang immediately decided to perform a cesarean section for the patient. At this time, the director of the neonatology department, the head nurse, and the director of the anesthesiology department are ready to rescue the newborn. Hu Guohuang and Deputy Director of Obstetrics Xu Wanhong performed emergency cesarean section and exploratory laparotomy + removal of peripancreatic necrotic tissue, abdominal drainage, pelvic drainage, and jejunostomy for Ms. Xiao. During the operation, a large amount of turbid exudate was seen in the abdominal cavity. The pancreas is noticeably swollen. After birth, the newborn had only a weak heartbeat. After a tense and orderly asphyxia resuscitation, the newborn was successfully transferred to the Neonatology Department for further treatment.

Ms. Xiao underwent abdominal drainage after operation, and the abdominal pain was significantly relieved. At present, both mother and baby are recovering well. This life crisis was finally successfully overcome with the joint efforts of multidisciplinary experts from Changsha Fourth Hospital.

Department of Obstetrics and Chief Physician Zhang Yang said that acute pancreatitis in pregnancy is one of the more common surgical acute abdomens during pregnancy, with the characteristics of acute onset, many complications, difficult treatment and high mortality. , a serious threat to the health of mother and child, the common causes of biliary tract disease, abnormal lipid metabolism. Abdominal pain is a common symptom, which is more common after eating a high-fat diet or a full meal, which can lead to severe fetal hypoxia, stillbirth, fetal growth restriction, miscarriage or premature birth. In principle, the treatment is basically the same as the treatment of acute pancreatitis during non-pregnancy. If the disease is mild, there are no complications and organ dysfunction, conservative treatment can often achieve better results, and the pregnancy can be terminated after the disease is controlled. If the disease is critical, or Intrauterine distress occurs, the pregnancy should be actively terminated. The onset of Ms. Xiao’s condition is related to abnormal lipid metabolism during pregnancy, and a full meal is the incentive. Therefore, it is recommended to maintain a good diet and lifestyle during pregnancy, mainly light diet, and avoid over-full and high-fat diet, overeating, etc.

Changsha No. 4 Hospital, as a tertiary first-class hospital, is the treatment center for critically ill pregnant and lying-in women in Yuelu District. .