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Maternal choledochal cysts in pregnancy:A systematic review of case reports and case series

世界胃肠外科杂志:英文版(电子版) 2023年第8期15卷 1784-1798页

作者： Goran Augustin Ivan Romic Iva Miličić mislav Mikuš mislav herman Department of Surgery School of MedicineUniversity of ZagrebZagreb 10000Croatia School of Medicine University of Zagreb Zagreb 10000Croatia Department of Surgery University Hospital Centre ZagrebZagreb 10000Croatia Department of Obstetrics and Gynecology University Hospital Centre ZagrebZagreb 10000Croatia

BACKGROUND Choledochal cysts(CC)are cystic dilatations of the biliary tract,usually diagnosed during childhood,with an estimated incidence in the general population of 1:*** related to CC include rupture,biliary obstruction,and *** CC in pregnancy are rarely reported,and there are no guidelines on optimal *** To systematically review maternal CC diagnosed during pregnancy or postpartum with regard to the clinical presentation of CC,the mode of treatment and delivery,and maternal *** A literature search of cases and case series of maternal CC in pregnancy and postpartum was conducted using MEDLINE/PubMed,Web of Science,Google Scholar,and *** were no restrictions on language or publication *** were lastly accessed on September 1,*** Overall,71 publications met the inclusion criteria,reporting 97 ***-eight cases were diagnosed during pregnancy and nine in the *** most common symptoms were abdominal pain(81.2%)and jaundice(60.4%).Interventions for CC complications were required in 52.5%of the cases,and 34%of pregnancies were *** cesarean section(CS)was done in 24.7%.The maternal mortality was 7.2%,while fetal mortality was inconsistently ***,CC>15 cm,and bilirubin levels>80 mmol/L were associated with a higher likelihood of urgent CS and surgical intervention for *** levels positively correlated with CC *** was no correlation between age and cyst dimension,gestational age at cyst discovery,and CC *** Although rare,maternal CC in pregnancy should be included in the evaluation of jaundice with upper abdominal *** and clinical course are variable,and treatment may range from an expectative approach to emergent surgical CC treatment and urgent *** most cases were managed by conservative measures or drainage procedures,CC>15 cm and progressive cholangitis carry the risk of CC rupture and septic

关键词： Choledochal cyst Pregnancy Cholangitis Surgery Delivery Cesarean section

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Maternal diaphragmatic hernia in pregnancy:A systematic review with a treatment algorithm

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世界临床病例杂志 2023年第27期11卷 6440-6454页

作者： Goran Augustin Diana Kovač Vesna Sokol Karadjole Vendy Zajec mislav herman Pero Hrabač Department of Surgery University Hospital Centre ZagrebZagreb 10000Croatia Chair of Surgery School of Medicine University of ZagrebZagreb 10000Croatia Institute of Emergency Medicine of Dubrovnik-Neretva County Croatian Institute of Emergency MedicineDubrovnik 20000Croatia Department of Gynaecology and Obstetrics University Clinical Hospital Centre ZagrebZagreb 10000Croatia Department of Gynaecology and Obstetrics University Hospital Centre ZagrebZagreb 10000Croatia Department of Biostatistics "AndrijaŠtampar"School of Public HealthZagreb 10000Croatia

BACKGROUND Diaphragmatic hernia(DH)is extremely rarely described during *** to the rarity,there is no diagnostic or treatment algorithm for DH in *** To summarize and define the most appropriate diagnostic methods and therapeutic options for DH in pregnancy based on scarce *** Literature search of English-,German-,Spanish-,and Italian-language articles were performed using PubMed(1946–2021),PubMed Central(1900–2021),and Google *** PRISMA protocol was *** search terms included:Maternal diaphragmatic hernia,congenital hernia,pregnancy,cardiovascular collapse,mediastinal shift,abdominal pain in pregnancy,hyperemesis,diaphragmatic rupture during labor,puerperium,hernie diaphragmatique maternelle,hernia diafragmática *** studies were identified by reviewing reference lists of retrieved ***,imaging,surgical,and obstetric data were *** One hundred and fifty-eight cases were *** average maternal age increased across observed *** proportion of congenital hernias increased,while the other types appeared *** DHs were left-sided(83.8%).The median number of herniated organs declined across observed periods.A working diagnosis was correct in 50%.DH type did not correlate to maternal or neonatal *** access increased while thoracotomy varied across *** of less than 3 days carried a significant risk of strangulation in *** The clinical presentation of DH is easily confused with common chest conditions,delaying the diagnosis,and increasing maternal and fetal *** DH should be included in the differential diagnosis of pregnant women with abdominal pain associated with dyspnea and chest pain,especially when followed by *** diagnosis and immediate intervention lead to excellent maternal and fetal outcomes.A proposed algorithm helps manage pregnant women with maternal ***

关键词： Maternal diaphragmatic hernia Pregnancy Differential diagnosis Maternal mortality Fetal mortality Algorithm

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