产科直肠裂伤而无肛门括约肌损伤。
Obstetric rectal laceration in the absence of an anal sphincter injury.
机构信息
Obstetrics and Gynecology, The University of Arizona College of Medicine Tucson, Tucson, Arizona, USA
Obstetrics and Gynecology, University of South Florida, Tampa, Florida, USA.
出版信息
BMJ Case Rep. 2021 Aug 6;14(8):e243296. doi: 10.1136/bcr-2021-243296.
Rectal laceration in the absence of concurrent anal sphincter injury at the time of parturition is not a frequently reported finding. This rarely encountered injury is also referred to as a buttonhole injury. It is a disruption of the vaginal and rectal tissue with resultant disruption of the anal epithelium in the setting of an intact external anal sphincter. A 30-year-old gravida 1 para 0 at 39 weeks presented for induction of labour due to chronic hypertension. During her labour course, she developed with superimposed preeclampsia with severe features and magnesium sulfate was initiated. She underwent a spontaneous vaginal delivery of an infant weighing 3840 g. Following delivery, stool was visualised in the vagina. A rectal examination revealed a rectovaginal defect separate from the second-degree perineal laceration, which extended proximally to the cervix. The anal sphincter was noted to be intact with good tone. Both defects were repaired, and she had an uncomplicated recovery.
分娩时无同时性肛门括约肌损伤的直肠裂伤并不常见。这种罕见的损伤也被称为扣眼损伤。它是阴道和直肠组织的破裂，导致肛门上皮在完整的外部肛门括约肌的情况下破裂。一名 30 岁的初产妇，妊娠 39 周，因慢性高血压接受引产。在她的分娩过程中，她出现了严重特征的子痫前期，并开始使用硫酸镁。她自然分娩了一名体重 3840 克的婴儿。分娩后，阴道内可见粪便。直肠检查显示直肠阴道缺陷与二度会阴裂伤分开，向宫颈近端延伸。肛门括约肌被认为是完整的，张力良好。两个缺陷都得到了修复，她恢复顺利。
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