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一例膀胱阴道瘘手术修复后继发宫颈狭窄所致子宫积血病例

A Case of Haematometra Secondary to Cervical Stenosis after Vesicle Vaginal Fistula Surgical Repair.

作者信息

Lilungulu Athanase, Mwibea Willy, Nassoro Mzee, Gumodoka Balthazar

机构信息

Department of Obstetrics and Gynaecology, Dodoma University, College of Health Sciences, P.O. Box 395, Dodoma, Tanzania.

Department of Obstetrics and Gynaecology, Kibaha Clinical Officer Training College, P.O. Box 30282, Coast Regional, Tanzania.

出版信息

Case Rep Obstet Gynecol. 2017;2017:2303840. doi: 10.1155/2017/2303840. Epub 2017 Oct 8.

Abstract

. Haematometra is a rare postobstetrics fistula surgical repair outcome complication; however the condition can be misinterpreted especially in limited resource areas that lack routine ultrasound guidance and with a slowly progressed increase in size of abdomen accompanied with a history of amenorrhoea together with a history of having unprotective sexual intercourse which may increase the possibility of being controversial to full-term gravid uterus. The causes of haematometra might be either due to congenital abnormality of the vaginal canal or acquired iatrogenically. However, any other cause that involved vaginal canal can be a predisposing factor of haematometra. We present a case of a 32-year-old female patient, who had obstetric fistula which was successfully repaired over the past two years. She presented with one-year-and-two-month history of an amenorrhoea that was progressive accompanied with distended abdomen to the extent of looking typically as the gravid uterus. Explorative laparotomy was performed successfully and surgical incision managed by hysterotomy and salpingotomy, whereby approximately ten liters of serosanguinous blood fluid mixed with blood clots was completely suctioned. Despite being a rare condition after vesicle vaginal fistula repair complication outcome, haematometra remains to be relatively common gynaecological condition among female adolescence during postpubertal period.

摘要

经血潴留是一种罕见的产科瘘管手术修复后并发症;然而,这种情况可能会被误诊,尤其是在缺乏常规超声引导的资源有限地区,且腹部逐渐增大,伴有闭经史以及无保护性交史,这可能会增加与足月妊娠子宫混淆的可能性。经血潴留的原因可能是阴道先天性异常或医源性后天获得性。然而,任何涉及阴道的其他原因都可能是经血潴留的诱发因素。我们报告一例32岁女性患者,她两年前成功修复了产科瘘管。她出现了一年零两个月的渐进性闭经,伴有腹部膨隆,看起来典型地像妊娠子宫。成功进行了剖腹探查术,通过子宫切开术和输卵管切开术处理手术切口,吸出了大约10升浆液性血性液体和血凝块。尽管经血潴留是膀胱阴道瘘修复并发症后罕见的情况,但在青春期后女性中仍是相对常见的妇科疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f15/5654339/84ba4220ad24/CRIOG2017-2303840.001.jpg

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