Kazmi Zainab, Gupta Sujata, Dobson Michael
University of Manchester School of Medicine, Stopford Building, Oxford Road, Manchester, M13 9PT UK ; Women's Health Directorate, Royal Preston Hospital, Sharoe Green Lane North, Preston, Lancashire PR2 9HT UK.
Women's Health Directorate, Royal Preston Hospital, Sharoe Green Lane North, Preston, Lancashire PR2 9HT UK.
Gynecol Surg. 2016;13:43-48. doi: 10.1007/s10397-015-0925-1. Epub 2015 Dec 9.
Hydrosalpinx is a rare cause of abdominal pain in paediatric patients, though cases are documented in the literature. Its aetiology differs considerably from traditional hydrosalpinx due to ascending sexually transmitted infection. Hydrosalpinx can resent mimicking an acute abdomen or can be asymptomatic. Management of paediatric hydrosalpinx varies but often involves surgical removal of the affected tube. A 12-year-old girl presented with left-sided acute abdominal pain setting within 24 h. Initial ultrasound scan suggested presence of hydrosalpinx. Post-discharge follow-up appointment with a consultant paediatric gynaecologist demonstrated no symptomology, but repeated scan by another sonographer showed continued presence of possible hydrosalpinx, which had since grown. Later, MRI was performed to confirm site of the lesion. However, MRI revealed no tubal masses, suggesting spontaneously resolved hydrosalpinx. Consultant-administered ultrasound scan confirm no tubal abnormalities. Our case suggests spontaneous resolution in possible paediatric hydrosalpinx. Our recommendation is for conservative management of asymptomatic paediatric and adolescent hydrosalpinges, with emergency surgery offered if symptoms indicative of tubal or adnexal torsion.
输卵管积水是小儿腹痛的罕见原因，尽管文献中有相关病例记载。其病因与因性传播感染上行所致的传统输卵管积水有很大不同。输卵管积水可能表现为类似急腹症，也可能无症状。小儿输卵管积水的治疗方法各异，但通常需要手术切除患侧输卵管。一名12岁女孩在24小时内出现左侧急性腹痛。最初的超声扫描提示存在输卵管积水。出院后由儿科妇科顾问医生进行的随访检查未发现症状，但另一位超声检查人员的重复扫描显示可能仍存在输卵管积水，且此后积水有所增大。后来进行了MRI以确定病变部位。然而，MRI未发现输卵管肿块，提示输卵管积水已自行消退。顾问医生进行的超声扫描证实没有输卵管异常。我们的病例表明小儿输卵管积水可能会自行消退。我们建议对无症状的小儿和青少年输卵管积水进行保守治疗，若出现提示输卵管或附件扭转的症状则进行急诊手术。
