Cimsit Canan, Yoldemir Tevfik, Akpinar Ihsan Nuri
Department of Radiology, Marmara University Training and Research Hospital, Istanbul, Turkey.
J Obstet Gynaecol Res. 2016 Jul;42(7):890-894. doi: 10.1111/jog.12998. Epub 2016 Apr 14.
Catamenial sciatic radiculopathy resulting from endometriosis is a rare presentation of a common disease in which the pathogenesis of pain is still under debate. A 32-year-old woman presented complaining of infertility, catamenial sciatica, and pelvic and gluteal pain. Magnetic resonance imaging showed endometriotic infiltration of the left proximal lumbosacral plexus, sacral nerve track, sciatic nerve at the sciatic notch and pudendal nerve along the iliococcygeus muscle, together with left endometrioma and deep infiltrating endometriosis lesions. Laparoscopic endometriosis surgery was performed after all of the complications and possible outcomes of the surgery were discussed with the patient. Our case report highlights the importance of magnetic resonance imaging evidence of perineural spread, outlining the pathophysiology of the pelvic pain associated with neuroendometriosis.
由子宫内膜异位症引起的经期性坐骨神经痛是一种常见疾病的罕见表现，其疼痛的发病机制仍存在争议。一名32岁女性因不孕、经期性坐骨神经痛以及盆腔和臀痛前来就诊。磁共振成像显示左近端腰骶丛、骶神经束、坐骨切迹处的坐骨神经以及沿髂尾肌的阴部神经存在子宫内膜异位浸润，同时伴有左侧子宫内膜瘤和深部浸润性子宫内膜异位症病变。在与患者讨论了手术的所有并发症和可能结果后，进行了腹腔镜子宫内膜异位症手术。我们的病例报告强调了神经周围扩散的磁共振成像证据的重要性，概述了与神经子宫内膜异位症相关的盆腔疼痛的病理生理学。
