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腹腔镜切除宫颈后位和阴道直肠子宫内膜异位症后出现宫腔积血。

Hematometra following laparoscopic resection of retrocervical and rectovaginal endometriosis.

机构信息

Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD) and University Hospitals Strasbourg, Strasbourg, France.

出版信息

Fertil Steril. 2010 Apr;93(6):2074.e11-2. doi: 10.1016/j.fertnstert.2009.10.033. Epub 2010 Jan 13.

Abstract

OBJECTIVE

To report a case of hematometra following laparoscopic resection of rectovaginal endometriosis extending to the cervix.

DESIGN

Case report.

SETTING

University hospital.

PATIENT(S): A 31-year-old woman with endometriosis and infertility.

INTERVENTION(S): Combined laparoscopic and vaginal surgery.

RESULT(S): The cervix had retracted into the vaginal scar after surgery, preventing the escape of menstrual blood. The hematometra was drained, and the cervix was repositioned into the vagina with use of a combined vaginal and laparoscopic approach.

CONCLUSION(S): Retraction of the cervix into the cul-de-sac can occur as a complication of excision of rectovaginal nodules that extend onto the posterior surface of the cervix. Excision of the posterior cervix should avoid deep excision of the posterior lip and should be limited only to the ectocervical margin to avoid such complications.

摘要

目的

报告一例腹腔镜切除延伸至宫颈的直肠阴道子宫内膜异位症后发生宫腔积血的病例。

设计

病例报告。

地点

大学医院。

患者

一名 31 岁患有子宫内膜异位症和不孕症的女性。

干预措施

腹腔镜与阴道联合手术。

结果

术后宫颈回缩至阴道瘢痕内,阻止了月经血的排出。通过阴道和腹腔镜联合入路排出宫腔积血,并将宫颈重新置于阴道内。

结论

切除延伸至宫颈后表面的直肠阴道结节可能会导致宫颈回缩至子宫直肠陷凹,成为一种并发症。切除宫颈后唇时应避免过深,仅切除宫颈外口边缘,以避免此类并发症。

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