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子宫内膜间质结节切除术后并发宫颈重度粘连闭锁的诊治分析:一例报告

Analysis of diagnosis and treatment of complicated cervical severe adhesion atresia after removal of endometrial stromal nodule: A case report.

作者信息

Zhang Rui, Gu Pei, Liu Qi, Li Bin, Bai Wenpei

机构信息

Department of Obstetrics and Gynecology, Beijing Shijitan Hospital of Capital Medical University Beijing Shijingshan Hospital MRI room, Beijing Shijitan Hospital of Capital Medical University, Beijing, China.

出版信息

Medicine (Baltimore). 2017 Dec;96(48):e8979. doi: 10.1097/MD.0000000000008979.

Abstract

RATIONALE

Endometrial stromal nodule (ESN) is a rare benign endometrial stroma tumor.Experiences are helpful for avoiding and treating similar postoperative complications (cervical adhesions and atresia).

PATIENT CONCERNS

When appearing in the cervical, this tumor can easily lead to complications after the surgical resection. The diagnosis and postsurgery complication of a young woman's ESN was reported here.

DIAGNOSES

The postoperative pathological diagnosis was ESN.

INTERVENTIONS

A 29-year-old young woman was diagnosed and treated for ESN in cervical parts with postsurgery complications of cervical complex adhesion atresia.

OUTCOMES

The complication was complex cervix adhesion atresia with very special imaging performance-the cervix and the palace imaged as "Twisted and Angled Staircase." This particular cervix adhesion was challenging for operation. We achieved a successful treatment through the carefully designed surgical procedure including the application of hysteroscopy and laparoscopy.

LESSONS

The lower uterine segment and cervix should be paid attention during suturing in this situation. Close and positive follow-ups should be planned after the endometrial stromal resection. The reconstruction of the tunnel is a solution for the problem of menstruation.

摘要

原理

子宫内膜间质结节(ESN)是一种罕见的良性子宫内膜间质肿瘤。经验有助于避免和治疗类似的术后并发症(宫颈粘连和闭锁)。

患者关注点

当这种肿瘤出现在宫颈时,手术切除后很容易导致并发症。本文报道了一名年轻女性ESN的诊断及术后并发症情况。

诊断

术后病理诊断为ESN。

干预措施

一名29岁年轻女性因宫颈部位的ESN并伴有宫颈复杂粘连闭锁的术后并发症接受诊断和治疗。

结果

并发症为复杂的宫颈粘连闭锁,具有非常特殊的影像学表现——宫颈和子宫成像为“扭曲成角的楼梯”。这种特殊的宫颈粘连给手术带来了挑战。我们通过精心设计的手术程序,包括应用宫腔镜和腹腔镜,成功实现了治疗。

经验教训

在这种情况下缝合时应注意子宫下段和宫颈。子宫内膜间质切除术后应计划密切且积极的随访。隧道重建是解决月经问题的一种方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/687f/5728810/bde2b0898e57/medi-96-e8979-g001.jpg

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