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与用于标本取出的能量粉碎术相关的医源性寄生性肌瘤扭转。

Torsion of an iatrogenic parasitic fibroid related to power morcellation for specimen retrieval.

作者信息

Narasimhulu Deepa Maheswari, Eugene Ellis, Sumit Saraf

机构信息

Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, United States.

出版信息

J Turk Ger Gynecol Assoc. 2015 Nov 2;16(4):259-62. doi: 10.5152/jtgga.2015.15093. eCollection 2015.

Abstract

Parasitic fibroids are generally diagnosed incidentally at the time of surgery performed for symptomatic uterine fibroids. Torsion of a parasitic fibroid causing severe acute onset pain is extremely rare. We report a torsed parasitic fibroid in a patient who underwent hysterectomy using power morcellation for specimen retrieval. A 40-year-old patient with a history of laparoscopic supracervical hysterectomy 8 years prior presented with severe abdominal pain. She was diagnosed with degenerating parasitic fibroids on magnetic resonance imaging and was managed conservatively. Surgery was performed 3 days later for persistent pain, and the parasitic fibroid was found to have undergone torsion. Torsed ischemic fibroids can undergo necrosis and gangrene and can potentially cause life-threatening coagulopathy and peritonitis. Awareness of this potential complication will reduce errors in diagnosis and facilitate timely management.

摘要

寄生性子宫肌瘤通常在因有症状的子宫平滑肌瘤而进行手术时偶然被诊断出来。寄生性子宫肌瘤扭转导致严重急性发作性疼痛极为罕见。我们报告了一例在使用动力旋切术取出标本进行子宫切除的患者中发生扭转的寄生性子宫肌瘤。一名40岁患者,8年前有腹腔镜次全子宫切除术史,出现严重腹痛。磁共振成像诊断为退行性寄生性子宫肌瘤,并进行了保守治疗。3天后因持续疼痛进行手术,发现寄生性子宫肌瘤发生了扭转。扭转的缺血性子宫肌瘤可发生坏死和坏疽,并可能导致危及生命的凝血病和腹膜炎。认识到这种潜在并发症将减少诊断错误并促进及时治疗。

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