Algara Alfredo Cortes, Rodríguez Alfredo Góngora, Vázquez Alfredo Cortes, Valladares Florencia Elena Castañeda, Ramírez Pedro González, Padilla Eleazar Lara, Bandala Cindy, Hernández Saúl León
Centro Mexicano de Cirugía de Invasión Mínima, Hospital San Ángel Inn, Chapultepec, México.
Reproductive Endocrinology Division, Centro Mexicano de Cirugía de Invasión Mínima, Hospital San Ángel Inn, Chapultepec, México.
Surg Technol Int. 2015 Nov;27:195-7.
Leiomyomas are the most frequently solid tumors found in pregnancy. This kind of tumor has a wide incidence depending on the age, race, and type of population studied. Most of the cases have an asymptomatic course; however, they could develop different kinds of complications during the pregnancy such as severe abdominal pain, often due to degeneration or torsion with ischemia. In these cases, a surgical approach is required because these tumors do not respond to the conventional treatment. Very few of these cases are reported in the literature. We report the case of a 36-year-old woman pregnant 18 weeks, who experienced acute abdominal pain without initial reponse to regular analgesics. She was taken to the operating room, and under laparoscopic exploration, torsion of a subserosal myoma was observed. The fibroid was resected laparoscopically, and she was released from the hospital without complications. Unfortunately, she was readmitted 45 days later with signs of preterm labor because of a motorcycle accident. An emergency cerclage was performed, but the pregnancy was compromised with amnionitis and early fetal demise. We concluded that the laparoscopic approach could be a successful alternative treatment in selected cases.
平滑肌瘤是孕期最常见的实体瘤。这类肿瘤的发病率因研究人群的年龄、种族和类型而异。大多数病例病程无症状；然而，它们在孕期可能会出现不同类型的并发症，如严重腹痛，通常是由于变性或扭转伴缺血所致。在这些情况下，需要采取手术治疗，因为这些肿瘤对传统治疗无反应。文献中报道的此类病例很少。我们报告一例36岁、孕18周的女性，她经历了急性腹痛，起初常规镇痛药无效。她被送往手术室，在腹腔镜探查下，发现一个浆膜下肌瘤发生扭转。通过腹腔镜切除了肌瘤，她出院时无并发症。不幸的是，45天后她因摩托车事故出现早产迹象而再次入院。进行了紧急宫颈环扎术，但妊娠因羊膜炎和早期胎儿死亡而受到影响。我们得出结论，在某些特定病例中，腹腔镜手术可能是一种成功的替代治疗方法。
