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[子宫动静脉畸形作为突发性子宫出血的原因。多普勒超声的应用、其他成像方法及微创治疗]

[Uterine arteriovenous malformation as cause of uterine bleeding of sudden onset. Doppler ultrasound utility, other imaging methods and the minimally invasive treatment].

作者信息

Hernández-Escobar C E, Carrillo-Martínez M A, Arroyo-Lemarroy T, ZamoraMorales M T, Garza-García G A, Campos-Sanmiguel E

出版信息

Ginecol Obstet Mex. 2016 Aug;84(8):535-41.

PMID:29424516
Abstract

BACKGROUND

Uterine arteriovenous malformation is a rare disorder that can cause sudden life-threatening vaginal bleeding.

OBJETIVE

To present the clinical features in addition to the use of office gynecologic ultrasound and other imaging techniques in the diagnosis and minimally-invasive treatment of a patient with sudden vaginal bleeding resulting from a uterine arteriovenous malformation.

CASE REPORT

A 31 year old woman presented sudden onset vaginal bleeding requiring the transfusion of 3 units of red blood cells. An initial diagnosis of uterine arteriovenous malformation was made using an office gynecological ultrasound and Color Doppler sonography. The patient was referred to interventional radiology for confirmation of the diagnosis and patient care. The diagnosis and localization of the uterine arteriovenous malformation was confirmed using magnetic resonance imaging. Therapeutic management proceeded with superselective angiography and embolization of the supplying arteries resulting in immediate symptomatic resolution.

CONCLUSION

The use of office gynecologic ultrasound in combination with other imaging techniques is an important tool in the diagnosis and localization of uterine arteriovenous malformation. Embolization of supplying arteries is considered a safe and effective therapeutic option due to advances in radiologic intervention techniques. Advantages of this procedure include a minimally-invasive technique, low morbidity and preservation of uterine function.

摘要

背景

子宫动静脉畸形是一种罕见疾病,可导致危及生命的突发性阴道出血。

目的

介绍一名因子宫动静脉畸形导致突发性阴道出血患者的临床特征,以及门诊妇科超声和其他成像技术在诊断和微创治疗中的应用。

病例报告

一名31岁女性突发阴道出血,需要输注3单位红细胞。最初通过门诊妇科超声和彩色多普勒超声诊断为子宫动静脉畸形。该患者被转诊至介入放射科以确诊并接受治疗。通过磁共振成像确认了子宫动静脉畸形的诊断和定位。治疗采用超选择性血管造影和栓塞供血动脉,症状立即得到缓解。

结论

门诊妇科超声与其他成像技术相结合是诊断和定位子宫动静脉畸形的重要工具。由于放射介入技术的进步,栓塞供血动脉被认为是一种安全有效的治疗选择。该手术的优点包括微创技术、低发病率和保留子宫功能。

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