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输卵管旁子宫内膜异位症:一例报告

Paratubal endosalpingiosis: a case report.

作者信息

Mahdavi Fatemeh Sadat, Tavallaei Mehdi, Ketabforoush Arsh Haj Mohamad Ebrahim, Bahadorinia Mahsa

机构信息

Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.

Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

出版信息

Int J Surg Case Rep. 2020;77:839-842. doi: 10.1016/j.ijscr.2020.11.041. Epub 2020 Nov 27.

Abstract

INTRODUCTION

Endosalpingiosis is a rare condition and its pathogenesis and clinical significance are not fully understood. The unfamiliar presentation of this disease can misguide health care professionals. The reports available on this matter describe it as a disease of older age. In the majority of the cases it is an incidental finding in those with other concurrent gynecologic conditions.

PRESENTATION OF CASE

Here we report the case of a 14-year-old female who presented with abdominal pain and no specific past medical history. Imaging and physical examination were highly suggestive of appendicitis. With the initial diagnosis of acute abdomen, she underwent surgery. During the surgery gastrointestinal tract organs were found to be normal and in gynecological examination, the ovaries were normal, however the fallopian tube revealed a twisted paratubal cyst which was removed and sent to the laboratory for further investigation. On the basis of the cellular pathology, tubal like epithelium in the cyst was found and patient diagnosed with endosalpingiosis.

DISCUSSION

We suggest that in our case, the lesion possibly originated from the metaplasia of coelomic membrane into tubal cells. There are studies suggesting that co-occuring diseases should be considered when the diagnosis of endosalpingiosis is established and further studies are needed in regard to this matter.

CONCLUSION

Endosalpingiosis, although being a rare condition, should be included in our differential diagnosis since co-existing comorbidities are a possibility in patients with endosalpingiosis and can be of great importance.

摘要

引言

输卵管内膜异位症是一种罕见疾病,其发病机制和临床意义尚未完全明确。这种疾病不常见的表现可能会误导医护人员。关于此事的现有报告将其描述为一种老年疾病。在大多数情况下,它是在患有其他并发妇科疾病的患者中偶然发现的。

病例介绍

在此我们报告一例14岁女性病例,该患者出现腹痛且无特殊既往病史。影像学检查和体格检查高度提示阑尾炎。初步诊断为急腹症后,她接受了手术。手术中发现胃肠道器官正常,妇科检查时卵巢正常,但输卵管发现一个扭转的输卵管旁囊肿,将其切除并送实验室进一步检查。根据细胞病理学检查,囊肿中发现了输卵管样上皮,患者被诊断为输卵管内膜异位症。

讨论

我们认为在我们的病例中,病变可能起源于体腔膜化生为输卵管细胞。有研究表明,在确立输卵管内膜异位症诊断时应考虑合并存在的疾病,对此还需要进一步研究。

结论

输卵管内膜异位症虽然罕见,但应纳入我们的鉴别诊断范围,因为输卵管内膜异位症患者有可能存在合并症,且可能非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6439/7721654/1ce7dba4516f/gr1.jpg

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