单角子宫青春期女孩输卵管残端扭转合并非交通性残角子宫
Torsion of fallopian tube remnant associated with noncommunicating rudimentary horn in adolescent girl with unicornuate uterus.
作者信息
Blitz Matthew J, Appelbaum Heather
机构信息
Department of Obstetrics and Gynecology, Hofstra North Shore-LIJ School of Medicine, New York, NY.
Department of Obstetrics and Gynecology, Hofstra North Shore-LIJ School of Medicine, New York, NY; Division of Pediatric and Adolescent Gynecology, Cohen Children's Medical Center of New York, New York, NY.
出版信息
J Pediatr Adolesc Gynecol. 2014 Oct;27(5):e97-9. doi: 10.1016/j.jpag.2013.07.012. Epub 2013 Dec 9.
BACKGROUND
The prevalence of müllerian anomalies may be as high as 7% in the general population, yet there is scant published literature on adnexal torsion occurring in these patients.
CASE
A 14-year-old female presented with right lower quadrant pain. Pelvic ultrasonography demonstrated a 2-cm simple right adnexal cyst. Diagnostic laparoscopy revealed a unicornuate uterus with a normal left uterine horn and fallopian tube but atretic and cordlike müllerian structures on the right side. Torsion of the right tubal remnant and two paratubal cysts were noted and the structures were then excised.
SUMMARY AND CONCLUSION
Agenesis, hypoplasia, or maldevelopment of müllerian structures may predispose patients to an increased risk of adnexal torsion secondary to looser ligamentous attachments and consequent lack of fixation to the pelvic sidewall.
背景
苗勒管异常在普通人群中的患病率可能高达7%，然而关于这些患者发生附件扭转的已发表文献却很少。
病例
一名14岁女性因右下腹疼痛就诊。盆腔超声检查显示右侧附件有一个2厘米的单纯性囊肿。诊断性腹腔镜检查发现单角子宫，左侧子宫角和输卵管正常，但右侧为闭锁的条索状苗勒管结构。发现右侧输卵管残端扭转及两个输卵管旁囊肿，随后切除这些结构。
总结与结论
苗勒管结构的发育不全、发育不良或发育异常可能使患者因韧带附着较松弛以及因此缺乏与盆腔侧壁的固定而增加附件扭转的风险。
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