隐匿性阴道脏器脱出：一例病例报告
Occult Vaginal Evisceration: A Case Report.
作者信息
Shehata Fady, Bougie Olga, Baker Kevin, Khalil Hisham
机构信息
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, ON.
Department of Obstetrics and Gynaecology, Queens University, Kingston, ON.
出版信息
J Obstet Gynaecol Can. 2019 Sep;41(9):1341-1343. doi: 10.1016/j.jogc.2018.11.025. Epub 2019 Jan 25.
BACKGROUND
Vaginal evisceration is a rare gynaecologic emergency that necessitates surgical intervention. It may manifest with obvious vaginal rupture, or it may be occult, specifically in patients with chronic pelvic organ prolapse.
CASE
A 66-year-old woman with a history of bowel cancer and irradiation presented with occult vaginal evisceration. This was discovered during a routine follow-up appointment. It was repaired in two layers with xenograft derived from porcine intestinal mucosa (Surgisis, Cook Medical, Bloomington, IN) interposition and a concomitant colpocleisis. Long-term complications of the procedure included recurrent prolapse, but her vaginal vault evisceration did not recur.
CONCLUSION
In patients with chronic pelvic organ prolapse, especially in those with additional risk factors for poor tissue strength, the possibility of vaginal vault evisceration or dehiscence should be considered. These patients would benefit from close follow-up.
背景
阴道脏器膨出是一种罕见的妇科急症，需要手术干预。它可能表现为明显的阴道破裂，也可能隐匿存在，特别是在患有慢性盆腔器官脱垂的患者中。
病例
一名66岁有肠癌和放疗史的女性出现隐匿性阴道脏器膨出。这是在一次常规随访预约中发现的。采用猪小肠黏膜来源的异种移植物（Surgisis，库克医疗公司，印第安纳州布鲁明顿）置入并同时进行阴道闭合术分两层进行修复。该手术的长期并发症包括复发脱垂，但她的阴道穹窿脏器膨出未复发。
结论
在患有慢性盆腔器官脱垂的患者中，尤其是那些存在组织强度差的额外危险因素的患者，应考虑阴道穹窿脏器膨出或裂开的可能性。这些患者将受益于密切随访。
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