Brito L G O, Magnani P S, de Azevedo Trapp A Eugênio, Sabino-de-Freitas M M
Department of Gynecology and Obstetrics, Urogynecology Division, Faculty of Medicine of Ribeirão Preto, São Paulo University Ribeirão Preto, SP, Brazil.
Clin Exp Obstet Gynecol. 2011;38(3):299-300.
We present a case of a 45-year-old woman who presented with irregular vaginal bleeding and menorrhagia for two months, with an episode of massive bleeding initiating 24 hours before with hemodynamic shock. Vaginal inspection showed a soft, rounded, friable mass in vaginal introitus. After hospitalization, blood transfusion and hydration, she was submitted to vaginal myomectomy with the withdrawal of a 12-cm white, solid, huge, pedunculated, leiomyoma; however, hysterectomy was performed due to persistent uterine bleeding. The postoperation period had no complications. Macroscopy showed a retraction of the myoma pedicle. Gynecologists should prioritize clamping of a pedicle before surgery, reducing its size if the tumor is large.
我们报告一例45岁女性，她出现不规则阴道出血和月经过多两个月，在入院前24小时发生一次大出血并伴有血流动力学休克。阴道检查发现阴道入口处有一个柔软、圆形、易碎的肿块。住院后，在输血和补液治疗后，她接受了阴道肌瘤切除术，切除了一个12厘米长的白色、实性、巨大、有蒂的平滑肌瘤；然而，由于子宫持续出血，最终进行了子宫切除术。术后无并发症。肉眼检查显示肌瘤蒂回缩。妇科医生在手术前应优先夹住蒂部，如果肿瘤较大则应缩小其尺寸。
