임신 제3삼분기에 aspartate transaminase/alanine transaminase (AST/ALT) 상승을 동반한 소장폐색 1예
A case of small bowel obstruction with elevated aspartate transaminase/alanine transaminase (AST/ALT) in the third trimester of pregnancy
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임신 중 장폐색은 드물고 조기 진단과 치료가 필요한 질환이다. 그러나 전형적인 증상인 오심과 구토 및 복통 같은 증상들은 임신기간 동안 발생할 수 있고, 임신기간 중에는 방사선학적인 검사를 피하기 때문에 진단이 늦어질 수 있다. 더욱이 상기 증상과 aspartate transaminase/alanine transaminase (AST/ALT) 상승이 동반된 경우 임신 중 급성 지방간이나 자간전증을 함께 의심해 볼 수 있기 때문에 진단이 더욱 늦어질 수 있다. 그러나 진단이 늦어질 경우 모성 및 주산기 사망률이 높은 질환이다. 따라서 이전에 복부수술의 경력이나 상기 증상을 고려하여 장폐색을 의심해 보고, 단순 복부 x‐ray검사 등을 통해 조기에 진단을 하여 수술을 신속히 진행하는 것이 필요하다. 이에 저자들은 이전에 제왕절개수술을 한 산모에서 AST/ALT 상승을 동반한 소장폐색의 1예를 문헌고찰과 함께 보고하는 바이다.
Abstract
The intestinal obstruction during pregnancy is rare but early diagnosis and treatment is essential. This disease can be diagnosed very late because the presenting symptoms such as nausea, vomiting and abdominal pain are often seen in normal pregnancies and most pregnant women avoid radiologic examinations. Moreover, this disease can be accompanied by high aspartate transaminase/alanine transaminase (AST/ALT) which can be also found in acute fatty liver of pregnancy or preeclampsia, and it makes diagnosis to be much delayed. If the diagnosis were delayed much, maternal and perinatal mortality would be increased highly. Therefore, the previous record of abdominal surgery or above mentioned symptom should be considered as the intestinal obstruction, and simple abdominal x‐ray for early diagnosis and prompt operation step are critical. We present a case of small bowel obstruction accompanied with high AST/ALT during pregnancy which had the history of previous cesarean section with a brief review of the literature.
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