Case Reports Journal Article Epublish
PubMed: 42770159 DOI: 10.14309/crj.0000000000002322
Refractory Inflammatory Bowel Disease in Pregnancy: Multidisciplinary Management With Timely Surgery and Ultrasound Monitoring.
ACG Case Rep J 13(9):e02322
Authors: Leshni Pillay, Maddison Terlato, Dimity Keam, Iniyaval Ini Thevathasan, Fiona Chan, Zaid Ardalan, Aysha Al-Ani, Britt Christensen
Affiliations
- Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
- Maternity Department, Royal Women's Hospital, Parkville, Victoria, Australia.
- Department of Anatomical Pathology, Royal Women's Hospital, Parkville, Victoria, Australia.
Abstract
Management of medically refractory inflammatory bowel disease during pregnancy remains challenging due to limited evidence regarding rescue therapy, surgical timing, and fetal safety. We report a case of third-trimester inflammatory bowel disease-unclassified treated with accelerated infliximab rescue therapy and serial intestinal ultrasound monitoring. Persistent clinical, biochemical, and sonographic disease activity despite intensive medical therapy prompted multidisciplinary decision making, culminating in combined lower segment caesarean section and left hemicolectomy at 33+6 weeks gestation. This case highlights the value of multidisciplinary care and serial intestinal ultrasound as an adjunctive objective tool to support therapeutic escalation and surgical decision making in pregnancy.
MeSH
Pregnancy, Decision Making, Inflammatory Bowel Diseases, Therapeutics