Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
J Minim Invasive Gynecol. 2013 Mar-Apr;20(2):244-7. doi: 10.1016/j.jmig.2012.10.006.
Primary amenorrhea caused by separation of the cervix from the uterine body resulting from pelvic trauma is exceptionally rare. This case report describes the diagnosis and successful laparoscopic approximation of traumatic separation of the cervix from the uterine corpus. A 16-year-old girl who was involved in a car accident at age 2 years had primary amenorrhea and cyclic abdominal pain. A closed pelvic fracture was managed nonsurgically, with an uneventful recovery. Since age 13 years, the patient has been experiencing cyclic abdominal pain. Ultrasonography suggested a 5-cm left adnexal mass. Diagnostic laparoscopy revealed complete separation of the uterine corpus from the cervix, and an endometrioma in the left ovary. The uterine corpus was approximated to the cervix with circumferentially placed sutures under direct laparoscopic guidance. The endometrioma was resected concomitantly. Normal cyclic menstruation resumed 2 months postoperatively, without cyclic abdominal pain. This case report demonstrates successful laparoscopic approximation of traumatic separation of the uterine corpus from the cervix, manifested as primary amenorrhea.
创伤性宫颈与子宫体分离导致原发性闭经极为罕见。本病例报告描述了创伤性宫颈与子宫体分离的诊断和成功的腹腔镜治疗。一位 16 岁的女孩在 2 岁时遭遇车祸，导致原发性闭经和周期性腹痛。采用非手术方法治疗闭合性骨盆骨折，恢复顺利。自 13 岁以来，患者一直经历周期性腹痛。超声检查提示左侧附件区有一个 5 厘米的肿块。诊断性腹腔镜检查显示子宫体完全与宫颈分离，左侧卵巢有一个子宫内膜瘤。在腹腔镜直接引导下，通过环绕宫颈和子宫体的缝线将其缝合。同时切除子宫内膜瘤。术后 2 个月恢复正常周期性月经，无周期性腹痛。本病例报告显示，腹腔镜下成功治疗了创伤性宫颈与子宫体分离导致的原发性闭经。
