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诊断与处理难点:儿童子宫扭转。

A Challenge in Diagnosis and Management: Uterine Torsion in Childhood.

机构信息

Department of Obstetrics & Gynaecology, Ampang Hospital, Ampang, Selangor, Malaysia.

Department of Obstetrics & Gynaecology, Ampang Hospital, Ampang, Selangor, Malaysia.

出版信息

J Pediatr Adolesc Gynecol. 2021 Feb;34(1):61-64. doi: 10.1016/j.jpag.2020.09.003. Epub 2020 Oct 1.

Abstract

BACKGROUND

Uterine torsion is a rare event, which mostly reported in females with a gravid uterus and is exceptionally rare in children.

CASE

A 9-year-old girl presented with 3 days of intermittent lower abdominal pain. Ultrasound revealed an ovarian mass, but laparotomy revealed an ischemic enlarged ovary and uterus rotated 180°. No reperfusion occurred after 60 minutes. A subtotal hysterectomy and right salpingoophorectomy were thus performed.

CONCLUSION

Uterine and adnexal torsion presents with symptoms similar to those of adnexal torsion. Delays in diagnosis and referral continue to be an issue, resulting in suboptimal outcomes. Uterine torsion, although exceedingly rare in childhood, appears to occur only in the setting of ovarian masses, which provide the impetus for the rotational force to the elongated cervix of the prepubertal uterus.

摘要

背景

子宫扭转是一种罕见的情况,主要发生在怀有子宫的女性中,在儿童中极为罕见。

病例

一名 9 岁女孩因间歇性下腹疼痛 3 天就诊。超声显示卵巢肿块,但剖腹探查显示卵巢和子宫缺血性增大,旋转 180°。60 分钟后未再灌注。因此行次全子宫切除术和右侧输卵管卵巢切除术。

结论

子宫和附件扭转的症状与附件扭转相似。诊断和转诊的延误仍然是一个问题,导致结果不理想。子宫扭转虽然在儿童中极为罕见,但似乎仅发生在卵巢肿块的情况下,卵巢肿块为青春期前子宫的细长宫颈提供了扭转力的动力。

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