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以复发性大量出血性腹水为表现并经粗针活检确诊的子宫内膜异位症:一例报告

Endometriosis presenting with recurrent massive hemorrhagic ascites and diagnosed by core needle biopsy: A case report.

作者信息

Wang Xue, Li Yiling, Tong Jing, Chang Bing, Zhang Yi, Liu Yanjun, Bing Hao, Guo Liping, Li Dan

机构信息

Department of Gastroenterology.

Department of Gynaecology and Obstetrics.

出版信息

Medicine (Baltimore). 2019 May;98(19):e15477. doi: 10.1097/MD.0000000000015477.

Abstract

RATIONALE

Recurrent massive hemorrhagic ascites secondary to endometriosis is extremely rare in the medical literature.

PATIENT CONCERNS

We report the case of a 24-year-old nulliparous woman presenting with severe abdominal distention, massive ascites, moderate anemia, menstrual pain, and an elevated CA-125 level.

DIAGNOSIS

We found a thickened peritoneum in the left lower abdomen by ultrasound during the follow-up period, and endometriosis was subsequently diagnosed by performing core needle biopsy (CNB).

INTERVENTIONS AND OUTCOMES

The patient received medical treatment for endometriosis and had a good response to the treatment.

LESSONS

This is the first case in which endometriosis ectopic to peritoneum was diagnosed by CNB. Endometriosis should be considered a differential diagnosis when recurrent massive hemorrhagic ascites occur. CNB should be valued as a method for diagnosing endometriosis.

摘要

理论依据

子宫内膜异位症继发复发性大量出血性腹水在医学文献中极为罕见。

患者情况

我们报告了一名24岁未生育女性的病例,该患者出现严重腹胀、大量腹水、中度贫血、痛经以及CA-125水平升高。

诊断

随访期间超声检查发现左下腹腹膜增厚,随后通过粗针穿刺活检(CNB)确诊为子宫内膜异位症。

干预措施及结果

患者接受了子宫内膜异位症的药物治疗,治疗反应良好。

经验教训

这是首例通过CNB诊断腹膜异位子宫内膜异位症的病例。当出现复发性大量出血性腹水时,应考虑子宫内膜异位症作为鉴别诊断。CNB应被视为诊断子宫内膜异位症的一种方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2195/6531191/82542437df7a/medi-98-e15477-g001.jpg

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