Pregnancy with Large Intra-Abdominal Tumor – Case Report

Abstract

Abstract: The aim of this case report, is to make a Clinical presentation of a rare case of pregnancy, followed by large intra-abdominal intestinal tumor, which compromised the pregnancy and it was the reason for premature delivery. This tumor was diagnosed in 32 estational week of the pregnancy, when patient started with the symptoms of sudden and extreme vomiting and collapsing. She was hospitalized at the Department of Pathologic Pregnancies at Gynecology and Obstetrics Clinic in Skopje, after she was sent from a Clinical Hospital- Shtip, were she was first hospitalized. During the hospitalization at our Department, she undergo several Obstetrics and abdominal ultrasound examinations, hematological examinations, serological and infective examinations, tumor markers, gastroscopy and MRI which shown large abdominal intra peritoneal tumor located under the liver and gaster, dislocated the bowels toward the lower and the frontal part of the abdomen. The patient was submitted to a rehydration and symptomatic therapy, double antibiotic, anti anemic and thromboprophylactic therapy to relieve the symptoms of vomiting and exhaustion. A fetal maturation with Flosteron 14mg was provided for two days, in 2 doses, within a period of 18 days. The premature delivery was planned with a surgeon. The patient gave birth 21 days after her hospitalization in the 35-th week of the pregnancy, with a Cesarean section and a medial infra umbilical incision. She gave birth to a living 2200 g male, 44 cm long with APGAR score 7/8. The Cesarean section was followed by opening of the upper abdomen with para- and supra umbilical incision and after the large abdominal tumor was removed by abdominal surgeon, it was sent to Pathohysthological examination. The pathohystologic diagnosis was: Adenocarcinoma intestini crassi Stage II b. In rare cases, pregnancy can be compromised by large intra-abdominal tumors which can put the health of both, the mother and the fetus in danger. The entire pregnancy period should be carefully observed, too, since the symptoms can sometimes lead to interdisciplinary examinations and consultations with other specialists.