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一例因女性割礼继发外阴肿胀的病例,造成了诊断难题。

A case of vulval swelling secondary to female circumcision posing a diagnostic dilemma.

作者信息

Amu Okwudili C, Udeh Emeka I, Ugochukwu Anthony I, Madu Chukwudi, Nzegwu Martin A

机构信息

Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria.

出版信息

Int J Surg Case Rep. 2012;3(9):431-4. doi: 10.1016/j.ijscr.2012.03.038. Epub 2012 May 24.

Abstract

INTRODUCTION

The practice of FGM is most prevalent in the African countries such as Nigeria, Ethiopia, Sudan, Egypt, and some area of the Middle East. It is not restricted to any ethnic, religious or socioeconomic class. There are many reasons for perpetuation of this practice; the most common are cultural and religious beliefs. The aim of this paper is to highlight the diagnostic dilemma associated with this type of case and the psychological trauma of a patient following her unfortunate genital mutilations.

PRESENTATION OF CASE

We present the case of epidermal inclusion dermoid cyst in an 18-year-old teenage girl referred to us from the gynecologist as a case of hydrocoele of the canal of Nuck involving the left labia majora. Patient was previously seen by general practitioner who diagnosed a left Bartholins cyst. Excision of the mass, revealed a well encapsulated cystic mass containing serous fluid with no extension to the inguinal area, measured 10cm×8cm. Histology showed epidermoid inclusion dermoid cyst probably related to circumcision (female genital mutilation).

DISCUSSION

Implantation dermoid cyst though a recognized complication of FGM is rare in our environment and a high index of suspicion is required any time a girl presents with a vulval swelling. Cosmesis still remains the watchword to assuage the psychological impact on the patient.

CONCLUSION

There is need for more public health campaigns to educate communities about the harms of circumcision with the goal of eradicating the practice.

摘要

引言

女性生殖器切割的做法在尼日利亚、埃塞俄比亚、苏丹、埃及等非洲国家以及中东的一些地区最为普遍。它不受任何种族、宗教或社会经济阶层的限制。这种做法长期存在有许多原因;最常见的是文化和宗教信仰。本文的目的是突出与这类病例相关的诊断困境以及患者在不幸接受生殖器切割后的心理创伤。

病例介绍

我们介绍一名18岁少女的表皮包涵体皮样囊肿病例,该病例由妇科医生转诊给我们,诊断为努克管鞘膜积液累及左侧大阴唇。患者曾看过全科医生,被诊断为左侧巴氏腺囊肿。肿块切除后,发现一个包膜良好的囊性肿块,内含浆液性液体,未延伸至腹股沟区,大小为10厘米×8厘米。组织学检查显示表皮包涵体皮样囊肿可能与割礼(女性生殖器切割)有关。

讨论

植入性皮样囊肿虽是女性生殖器切割公认的并发症,但在我们的环境中很少见,任何时候女孩出现外阴肿胀都需要高度怀疑。美容仍然是减轻对患者心理影响的关键。

结论

需要开展更多的公共卫生运动,向社区宣传割礼的危害,以根除这种做法。

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