alexa Ectopic Decidua Presenting With a Sigmoid Bowel Perforation: A Case Report
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Ectopic Decidua Presenting With a Sigmoid Bowel Perforation: A Case Report

Audrius Gradauskas1,2*, Jonas Činčikas2, Ričardas Daunoravičius3, Ugnius Mickys6, Giedrius Mazarevičius2, Ieva Šataitė2, Valdemaras Jotautas4, Dileta Rutkauskaitė5, and Kęstutis Strupas4
1Department of Nursing and Fundamentals of Internal Medicine, Faculty of Medicine, Vilnius University, Universiteto g.3, LT-01513, Vilnius, Lithuania
2Department of Abdominal Surgery, Vilnius City Clinical Hospital, Antakalnio g. 57, LT-10207, Vilnius, Lithuania
3Second Department of Obstetrics, Vilnius City Clinical Hospital, Antakalnio g. 57, LT-10207, Vilnius, Lithuania
4Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Lithuania
5Department of Radiology, Nuclear Medicine and Medical Physics, Faculty of Medicine, Vilnius University, Lithuania
6National Pathology Center, P. Baublio 5, LT-08406, Vilnius, Lithuania
Corresponding Author : Dr. Audrius Gradauskas
Department of Nursing and Fundamentals of Internal Medicine
Faculty of Medicine, Vilnius University
Universiteto g.3, LT-01513, Vilnius, Lithuania
Tel: +370 685 44800
Fax: +370 5 2346966
E-mail: [email protected]
Received June 02, 2012; Accepted July 06, 2012; Published July 08, 2012
Citation: Gradauskas A, Cincikas J, Daunoravicius R, Mickys U, Mazarevicius G, et al. (2012) Ectopic Decidua Presenting With a Sigmoid Bowel Perforation: A Case Report. J Clin Case Rep 2:168. doi:10.4172/2165-7920.1000168
Copyright: © 2012 Gradauskas A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

The occurrence of ectopic decidua has been observed mostly in the ovaries, uterus and cervix. Ectopic gastrointestinal deciduosis is a physiological condition. Only several cases of ectopic decidua, causing complications have been presented in literature. To the best of our knowledge, sigmoid or any other bowel perforation, caused by deciduosis, has not been previously reported in literature. Case presentation: A 40-year old patient primigravida (32 weeks of gestation) was admitted with a severe abdominal pain and obstipation. An abdominal sonography was performed but no visual cause of the pain was diagnosed. Two days after admission the episode of severe pain reappeared. An abdominal sonography and x-ray showed “free air” under both domes of diaphragm. A laparotomy was performed. No perforation of hollow viscus was found. On the fifth postoperative day, the patient started to complain about acute abdominal pain. The decision was made to perform relaparotomy (a Caesarean section and reexploration of abdominal cavity during the same operation). During the relaparotomy a part of sigmoid colon was visually altered. A microperforation on tumour-like structures was found in the sigmoid colon. A Sigmoid resection was performed. Currently the patient has no residual complaints and is enjoying her motherhood. Conclusion: We assert that ectopic decidua can result in a perforation of the hollow viscus, which is a lifethreatening condition and should always be taken into account seriously. We believe that sigmoid microperforation could have found, we had taken a more aggressive approach and performed a Caesarean section during the first operation.

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