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子宫平滑肌瘤扭转——腹腔积血的罕见原因;病例报告及文献复习

Torsion of a uterine leiomyoma - a rare cause of hemoperitoneum; a case report and review of the literature.

作者信息

Levai Antonia Mihaela, Rotar Ioana Cristina, Muresan Daniel

机构信息

1st Department of Obstetrics and Gynecology, University of Medecine and Pharmacy "Iuliu Hatieganu", Cluj Napoca, Romania.

出版信息

Med Ultrason. 2019 Feb 17;21(1):77-82. doi: 10.11152/mu-1784.

Abstract

Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications are very rare. We present an unusual case of 38-year-old woman that came to the emergency department with acute abdominal pain. The ultrasound revealed hemoperitoneum, a uterus with two intramural fibroids and a tender inhomogeneous pelvic mass that seems to connect with the uterus. Computer tomographic (CT) examination raised the suspicion of a degenerated fibroid and hemoperitoneum. Emergency laparotomy was performed: the hemoperitoneum was determined by a degenerated fundal subserosalfibroid. Myomectomy was subsequently carried out. Even though this condition is extremely rare, every clinician has to bear in mind that acute fibroid complications can be a potential cause of acute abdominal pain that requires immediate surgery. The imagistic tools, ultrasound and CT are extremely helpful for the diagnosis.Due to its relative rarity in the second part of the article we have performed a review of the existing literature regarding the acute complications of fibroid torsion.

摘要

子宫平滑肌瘤是常见的子宫良性肿瘤,但相比之下,其急性并发症非常罕见。我们报告一例不同寻常的病例,一名38岁女性因急性腹痛前来急诊科就诊。超声检查显示有腹腔积血、一个有两个肌壁间肌瘤的子宫以及一个压痛的不均匀盆腔肿块,该肿块似乎与子宫相连。计算机断层扫描(CT)检查怀疑是肌瘤退变并伴有腹腔积血。遂进行急诊剖腹手术:腹腔积血是由一个退变的子宫底部浆膜下肌瘤所致。随后实施了肌瘤切除术。尽管这种情况极为罕见,但每位临床医生都必须牢记,肌瘤急性并发症可能是导致急性腹痛的潜在原因,需要立即进行手术。超声和CT等影像学检查手段对诊断极有帮助。由于其相对罕见,在本文第二部分我们对有关肌瘤扭转急性并发症的现有文献进行了综述。

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