{"title":"Refractory Inflammatory Bowel Disease in Pregnancy: Multidisciplinary Management With Timely Surgery and Ultrasound Monitoring.","authors":"Leshni Pillay, Maddison Terlato, Dimity Keam, Iniyaval Ini Thevathasan, Fiona Chan, Zaid Ardalan, Aysha Al-Ani, Britt Christensen","doi":"10.14309/crj.0000000000002322","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 9","pages":"e02322"},"PeriodicalIF":0.6000,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593037/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACG Case Reports Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14309/crj.0000000000002322","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/9/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
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.
期刊介绍：
ACG Case Reports Journal is a peer-reviewed, open-access publication that provides GI and hepatology fellows, private practice clinicians, and other healthcare providers an opportunity to share interesting case reports with their peers and with leaders in the field. ACG Case Reports Journal publishes case reports, images, videos and letters to the editor in all topics of gastroenterology and hepatology, including: Biliary Colon Endoscopy Esophagus Functional Bowel Disorders Inflammatory Bowel Disease Liver Nutrition and Obesity Pancreas Pathology Pediatric Small Bowel Stomach.
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