Shima Eiri, Serikawa Takehiro, Itsukaichi Mina, Haino Kazufumi, Ooki Izumi, Takakuwa Koichi, Tanaka Kenichi
Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan.
J Obstet Gynaecol Res. 2012 Aug;38(8):1111-4. doi: 10.1111/j.1447-0756.2011.01835.x. Epub 2012 Apr 30.
Uterine sacculation is rare complication affecting the pregnant uterus, and is difficult to diagnose. Sacculation consists of a transitory pouch or sac-like structure caused by inverted uterine polarity. Vaginal delivery is difficult, and even cesarean section can be difficult because of peculiar risks associated with uterine sacculation. We report a pregnant patient with posterior sacculation due to a huge myoma in the lower anterior uterine segment. Sacculation, especially that complicated by a huge myoma, is very difficult to accurately diagnose and makes cesarean section surgery challenging. Because of the myoma in our present case, opening the lower uterine segment was impossible with cesarean section. The uterus was instead opened by corporeal vertical cesarean section. Myomectomy was not performed and the giant myoma thus remained. Postoperative assessment revealed the uterus to still be retroverted. The giant myoma was the cause of sacculation in this case.
子宫袋状膨出是一种影响妊娠子宫的罕见并发症，难以诊断。袋状膨出是由子宫极性倒置引起的暂时性袋状或囊状结构。阴道分娩困难，甚至剖宫产也可能因与子宫袋状膨出相关的特殊风险而变得困难。我们报告一例因子宫下段前壁巨大肌瘤导致后壁袋状膨出的孕妇。袋状膨出，尤其是合并巨大肌瘤的情况，很难准确诊断，并且会使剖宫产手术具有挑战性。由于本例存在肌瘤，剖宫产时无法打开子宫下段。取而代之的是通过体部纵行剖宫产打开子宫。未进行肌瘤切除术，因此巨大肌瘤仍然存在。术后评估显示子宫仍为后倾。在本例中，巨大肌瘤是袋状膨出的原因。
