Koukoura Ourania, Kapsalaki Eftychia, Daponte Alexandros, Pistofidis George
Obstetrics and Gynaecology Department, University Hospital of Larissa, Larissa, Greece.
Department of Radiology, University Hospital of Larissa Thessaly, Larissa, Greece.
BMJ Case Rep. 2015 Oct 1;2015:bcr2015210358. doi: 10.1136/bcr-2015-210358.
We describe a rare case of a young woman with a large cystic adenomyotic lesion that was treated laparoscopically. The patient presented with severe dysmenorrhoea refractory to common analgaesics. She was initially diagnosed with right-sided ovarian endometrioma. MRI revealed a cystic lesion of 4 cm attached to the right uterine wall. Under laparoscopic vision, the uterine lesion was identified on the right portion of the uterine fundus close to the round ligament. Monopolar diathermy was used to dissect the lesion. When the incision reached the cystic cavity, dark-brown content flowed from the cyst. After resection was complete, the surgical wound was closed with two-layer interrupted sutures. The patient made a good recovery and was discharged the following day. Since patients with cystic adenomyosis are young, a minimally invasive procedure such as laparoscopic excision is considered optimal. The exact topography of the lesion is crucial in determining the site of the incision.
我们描述了一例罕见的年轻女性病例，该患者患有巨大的囊性子宫腺肌病病变，通过腹腔镜进行了治疗。患者表现为严重痛经，普通镇痛药治疗无效。她最初被诊断为右侧卵巢子宫内膜异位症。磁共振成像（MRI）显示一个4厘米的囊性病变附着于右侧子宫壁。在腹腔镜视野下，子宫病变位于子宫底部右侧靠近圆韧带处。使用单极透热法切除病变。当切口到达囊性腔时，深褐色内容物从囊肿流出。切除完成后，手术伤口用两层间断缝合关闭。患者恢复良好，次日出院。由于囊性子宫腺肌病患者较为年轻，像腹腔镜切除这样的微创手术被认为是最佳选择。病变的确切位置对于确定切口部位至关重要。
