NAKAMURA Shinichi    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor
Article types	Original article
Language	English
Peer review	Non peer reviewed
Title	A Patient with Crohn's Disease Who Gave Birth Despite Sigmoid Volvulus, Venous Thrombosis, Nontraumatic Fracture of the Rib, and Sepsis during Pregnancy
Journal	Formal name：Case reports in gastroenterology Abbreviation：Case Rep Gastroenterol ISSN code：16620631/16620631
Domestic / Foregin	Foregin
Volume, Issue, Page	17(1),pp.255-263
Author and coauthor	ITO Ayumi, MURASUGI Shun, YONEZAWA Maria, OMORI Teppei, NAKAMURA Shinichi, TOKUSHIGE Katsutoshi
Publication date	2023/08
Summary	The patient was a woman in her 40s who was diagnosed with Crohn's disease (CD) of the large and small intestines in 1996. In 2005, she was referred to our hospital for treatment. We treated her for 17 years with corticosteroids, biologics, immunosuppressive agents, 5-aminosalicylic acid, and nutrition care. However, her Crohn's Disease Activity Index remained between 200 and 250, indicating refractory CD. During her medical treatment, the patient also underwent 3 operations. One year ago, the patient became pregnant through in vitro fertilization. Even after pregnancy was confirmed, the patient continued her treatment for refractory CD with ustekinumab, granulocyte apheresis, and budesonide. Nonetheless, her CD was highly active during pregnancy, and she experienced various complications: sigmoid volvulus at gestational week 15, venous thrombosis at gestational week 17, nontraumatic rib fracture due to fetal movement at gestational week 32, and sepsis from central venous catheter infection at gestational week 37. At gestational week 38, the patient gave birth by emergency cesarian delivery. This paper reports details of the case in which delivery was achieved after various complications were overcome and discusses previous relevant reports.
DOI	10.1159/000531705
PMID	37928969