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.

中文翻译：

---

一名患有克罗恩病的患者，尽管在怀孕期间患有乙状结肠扭转、静脉血栓、非外伤性肋骨骨折和败血症，但仍顺利分娩。

患者为40多岁女性，1996年被诊断患有大小肠克罗恩病（CD）。2005年转诊至我院治疗。我们用皮质类固醇、生物​​制剂、免疫抑制剂、5-氨基水杨酸和营养护理治疗她 17 年。然而，她的克罗恩病活动指数仍保持在 200 至 250 之间，表明患有难治性 CD。在治疗期间，患者还接受了3次手术。一年前，患者通过体外受精怀孕。即使在确认怀孕后，患者仍继续使用乌特克单抗、粒细胞分离术和布地奈德治疗难治性 CD。尽管如此，她的 CD 在怀孕期间高度活跃，并且经历了各种并发症：妊娠第 15 周时发生乙状结肠扭转、妊娠第 17 周时发生静脉血栓、妊娠第 32 周时因胎动导致的非创伤性肋骨骨折以及妊娠第 32 周时因中心静脉导管感染而导致的败血症。妊娠第37周。妊娠第38周，患者紧急剖腹产。本文详细报道了克服各种并发症后顺利分娩的案例，并对以往的相关报道进行了讨论。