Affiliation:
1. Samara State Medical University
Abstract
Aim. To describe a clinical case of pregnancy and healthy labour in a young female patient with uncomplicated diverticular disease (DD).Key points. In recent years, DD is more frequently observed in younger patients. A 37-yo woman manifested the symptoms of periodic intense abdominal pain and constant abdominal discomfort. Colonic DD was diagnosed with irrigoscopy. A high-fibre diet, rifaximin-α at 400 mg twice a day for one week, once a month for six months, and topical anti-inflammatory therapy were prescribed. Clinical symptoms were eradicated upon the treatment. Unaware of pregnancy, the patient had another course of rifaximin-α at the second week of gestation, after which the therapy was stopped. Rifaximin-α, which has a poor intestinal absorption, did not affect the foetal development. A caesarean childbirth was healthy, the newborn was delivered on term with no complications (Apgar score 8).Conclusion. DD should be included in differential diagnosis for patients with non-specific symptoms (abdominal pain, bloating and discomfort), regardless of young age. No protocols are currently accepted for the DD management during gestation. In the clinical case reported, a patient having diverticular disease and a rifaximin-α therapy at an early term of gestation proceeded without complications for herself and the foetus.
Publisher
Russian Gastroenterolgocial Society
Reference16 articles.
1. Ivashkin V.T., Shelygin Yu.A., Achkasov S.I., Vasilyev S.V., Grigoryev Ye.G., Dudka V.V., et al. Diagnostics and treatment of diverticular disease of the colon: guidelines of the Russian gastroenterological Association and Russian Association of Coloproctology. Russ J Gastroenterol Hepatol Coloproctol. 2016;26(1):65–80 (In Russ.).
2. Tursi A. A critical appraisal of advances in the diagnosis of diverticular disease. Expert Rev Gastroenterol Hepatol. 2018;12(8):791–96 DOI: 10.1080/17474124.2018.1487288
3. Tursi A. Diverticulosis today: unfashionable and still under-researched. Therap Adv Gastroenterol. 2016;9(2):213–28. DOI: 10.1177/1756283X15621228
4. Zaidi E., Daly B. CT and clinical features of acute diverticulitis in an urban US population: rising frequency in young, obese adults. Am J Roentgenology. 2006;187(3):689–94. DOI: 10.2214/AJR.05.0033. PMID: 16928931
5. Schweitzer J., Casillas R.A., Collins J.C. Acute diverticulitis in the young adult is not “virulent”. Am Surg. 2002;68(12):1044–7.