Intestinal obstruction during pregnancy

　　The incidence of intestinal obstruction during pregnancy is higher than that during normal periods. The following is a specific introduction to the causes of this disease:

　　Due to the compression of the uterus on the intestinal loops, asymptomatic intestinal adhesions can form into intestinal obstruction due to compression or torsion.

　　Due to the short distance of the mesenteric root caused by congenital malformation, the intestinal peristalsis is restricted when the uterus is gradually enlarged. Excessive stretching and compression can also cause intussusception of the small intestine, leading to a narrow intestinal lumen and mechanical intestinal obstruction.

　　3, Perforation peritonitis caused by intestinal perforation during pregnancy or acute diffuse peritonitis, retroperitoneal hemorrhage or infection caused by mesenteric thrombosis can lead to paralytic intestinal obstruction.

　　4, During the second trimester of pregnancy when the uterus rises into the abdominal cavity and during the late pregnancy when the fetal head descends into the pelvis, or when the uterus suddenly contracts and returns to its original size after childbirth, intestinal loops may move abruptly, leading to intestinal obstruction. More than half of intestinal obstructions during pregnancy occur in the late pregnancy, with adhesive intestinal obstruction being the most common, followed by intussusception, volvulus, and malignant tumors.

　　Intestinal obstruction during pregnancy can lead to intestinal wall perforation, severe abdominal cavity infection, and toxic shock. When the passage of intestinal contents is blocked, a series of symptoms such as abdominal distension, abdominal pain, nausea, vomiting, and defecation disorders may occur. In severe cases, it can lead to impaired blood supply of the intestinal wall, followed by intestinal necrosis. If not treated actively, it can lead to death. The toxins produced by intestinal obstruction come from the products of bacteria and the decomposition products of necrotic tissue. The toxins enter the blood through the peritoneum, causing severe sepsis.

　　Intestinal obstruction during pregnancy is basically similar to that during non-pregnancy, but in the late pregnancy, the enlarged uterus occupies the abdominal cavity, the intestinal loops move to the back or sides of the uterus, or due to the relaxation of the abdominal wall after childbirth, the signs may be不明显 and atypical.

　　1, Abdominal pain:Abdominal pain is the main symptom of intestinal obstruction, usually presenting as persistent or intermittent colic, with pain usually located around the umbilicus, or may be on one side of the obstruction. The cause is that the passage of intestinal contents is blocked, and the peristalsis of the intestinal tract above the obstruction is enhanced, and the smooth muscle of the intestinal wall contracts and spasms strongly, causing intermittent severe colic.

　　2, Vomiting and bloating:Early vomiting is usually reflexive vomiting caused by intestinal distension, and thereafter, vomiting and bloating vary with the location of the obstruction. In cases of high intestinal obstruction, vomiting occurs early and frequently, and the vomit contains gastric and duodenal contents with a large amount of gastrointestinal fluid, pancreatic juice, and bile. Abdominal distension is usually not obvious; in cases of low intestinal obstruction, vomiting occurs late and less frequently, and late vomiting may contain intestinal contents with a fecal smell. Abdominal distension is generally severe and may be diffuse over the entire abdomen.

　　3, Defecation and flatus disorders:Incomplete intestinal obstruction and early high intestinal obstruction may have排气 and a small amount of defecation, while patients with complete intestinal obstruction no longer have排气 and defecation.

　　To prevent the occurrence of intestinal obstruction during pregnancy, it is necessary to pay attention to appropriate exercise during pregnancy (such as walking, etc.), eat more easily digestible and fiber-rich plant foods such as fruits and vegetables, and eat less animal foods. Especially do not eat too much high-protein and difficult-to-digest foods. Meat products can be cooked until they are soft before eating. For foods that are difficult to chew and easily form lumps, such as glutinous rice, grapes, mushrooms, bamboo shoots, animal tendons, and ligaments, try to eat less, especially for those who are constipated frequently. They should be more active, drink more water, eat more vegetables and fruits, and eat less spicy food in their daily life. In necessary cases, some drugs can be taken under the guidance of a doctor. In addition, actively preventing and treating various complications during pregnancy is also one of the important measures to prevent food-induced intestinal obstruction.

　　In the early stage of simple intestinal obstruction, there is no obvious change in the laboratory examination. In the late stage, accompanied by dehydration, blood concentration, electrolyte imbalance, and other changes, there may be corresponding changes in the laboratory examination, such as a significant increase in the total white blood cell count and neutrophils. When this happens, strangulated intestinal obstruction should be ruled out.

　　1. Abdominal X-ray透视 and flat film can show excessive distension of the intestinal tract and unequal amounts of gas-liquid interfaces.

　　2. Ultrasound examination can show the expansion of the intestinal cavity, the accumulation of gas, and the formation of a clear gas-liquid interface. If the initial examination is not clear, it can be re-examined 6 hours later. It usually takes 12 hours for a small intestinal obstruction to be diagnosed. A positive mobile dullness indicates that if ultrasound detects ascites, it is an important evidence of strangulated intestinal obstruction.

      Patients with intestinal obstruction during pregnancy generally have no special dietary requirements. It is recommended not to eat hard foods and to eat soft and loose foods. It is also necessary to pay attention to eating light foods in daily life and not to eat greasy, spicy, and irritating foods. It is also appropriate to drink more water..

　　The treatment of intestinal obstruction during pregnancy is the same as that during non-pregnancy. Non-strangulated intestinal obstruction can be treated conservatively under strict observation, that is, gastrointestinal decompression, intravenous fluid administration, correction of electrolyte and water imbalance, and injection of antibiotics; if there is no relief or peritonitis after 48 hours, surgery should be performed as soon as possible. Patients often suffer from hypovolemia, shock, and renal failure due to vomiting, edema of the intestinal wall, a large amount of exudate in the intestinal cavity, and loss of a large amount of fluid through gastrointestinal decompression. Strangulated intestinal obstruction should be operated on as soon as possible at any stage of pregnancy, and the aforementioned various non-surgical treatment measures should be adopted at the same time.