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[Gastric necrosis four years after fundoplication causing a dead foetus]
Ebbe Thinggaard1, Anders Peter Skovsen, Jeppe Kildsig
1Gastroenheden, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev. ebbe.thinggaard@gmail.com.
Ugeskrift for Laeger
|October 29, 2014
Summary
A pregnant woman with diabetic ketoacidosis developed gastric necrosis and perforation following fundoplication surgery. This rare complication led to fetal demise and required surgical intervention.
Area of Science:
- Gastroenterology
- Obstetrics
- Surgical Complications
Background:
- Diabetic ketoacidosis (DKA) in pregnancy presents significant maternal and fetal risks.
- Fundoplication is a surgical procedure for gastroesophageal reflux disease.
Observation:
- A 31-year-old pregnant woman with DKA experienced clinical deterioration.
- Imaging revealed intra-abdominal free fluid and air, prompting emergency surgery.
Findings:
- A necrotic 2x5 cm gastric wall perforation was identified.
- A non-viable fetus was delivered.
- The gastric necrosis was attributed as a complication of prior fundoplication.
Implications:
- This case highlights a rare but severe complication of fundoplication in a pregnant patient with DKA.
- It underscores the importance of considering surgical complications in pregnant patients with complex medical conditions.
- Early surgical intervention is critical for managing intra-abdominal emergencies in pregnancy.
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