Fever and right upper quadrant pain in a pregnant woman at 30 week's gestation

Laura E. Harrell, David T. Rubin, Stephen B. Hanauer

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: A 34-year-old gravid woman with a history of ileal Crohn's disease presented at 30 weeks' gestation with a 2-week history of fever and right upper quadrant pain. An intra-abdominal abscess was suspected. Ultrasound and MRI failed to demonstrate the suspected abscess. Owing to ongoing pain and fever, the risk to the fetus of a CT scan were discussed with the patient, obstetricians and radiologists, with considerable debate about the possibility of other explanations for her symptoms. Ultimately, a CT scan revealed marked thickening of the distal ileum and confirmed diagnosis of an abscess in continuity with the inflamed bowel. Investigations: Ultrasound, MRI, CT scan, urinalysis, urine culture and liver function tests. Diagnosis: Crohn's disease flare complicated by an intra-abdominal abscess. Management: Antibiotics (ceftizoxime, metronidazole and amoxicillin/clavulanate potassium), parenteral nutrition and ileocecectomy.

Original languageEnglish (US)
Pages (from-to)113-116
Number of pages4
JournalNature Clinical Practice Gastroenterology and Hepatology
Volume1
Issue number2
DOIs
StatePublished - Dec 1 2004

Keywords

  • CT scan
  • Crohn's disease
  • Intra-abdominal abscess
  • Pregnancy
  • Radiation

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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