Wang Lu, Jiang Yan-Jiao
Department of Gynecology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China.
World J Clin Cases. 2021 Oct 6;9(28):8524-8530. doi: 10.12998/wjcc.v9.i28.8524.
Endometriosis (EMs), an estrogen-dependent disease, refers to the appearance of mucosa-covered endometrial tissues (glandular and interstitial) growing in the uterine cavity outside the uterine myometrium. It is commonly seen in women aged 25 to 45, with an incidence of approximately 10%-15%.
A 35-year-old unmarried female who denied a history of sex with an intact hymen had multiple dysmenorrhea and pain in the left lower abdomen that recurred during menstruation. Ultrasound examination revealed a dark cystic area measuring 4.9 cm × 4.6 cm on the left side with poor light transmittance, which suggested a left endometriotic cyst. The patient was treated with pain medications (four capsules t.i.d., p.o.). After one month, computed tomography of the abdomen and pelvis revealed a low-density focus measuring approximately 38 mm in diameter, a blurred mesentery fat plane in the pelvic cavity, and pelvic effusion. Ultrasound showed a complex echo density measuring 5.2 cm × 3.0 cm × 4.2 cm in the left ovarian area and a fluid sonolucent area with a depth of 2.0 cm in the pelvic cavity. Left ovarian cystectomy, electrocautery for endometriotic lesions, myomectomy, and pelvic adhesion lysis were performed under laparoscopy. The postoperative diagnosis was left ovarian chocolate cyst rupture and EMs (stage III, ovarian type, peritoneal type).
Laparoscopic surgery can safely control the symptoms of EMs and effectively eradicate the disease.
子宫内膜异位症（EMs）是一种雌激素依赖性疾病，指子宫肌层外子宫腔内出现被黏膜覆盖的子宫内膜组织（腺体和间质）。常见于25至45岁女性，发病率约为10%-15%。
一名35岁未婚女性，处女膜完整，否认有性生活史，多次出现痛经，月经期间左下腹反复疼痛。超声检查显示左侧有一4.9 cm×4.6 cm的暗区囊性区域，透光度差，提示左侧子宫内膜异位囊肿。患者接受止痛药物治疗（口服，每日三次，每次四粒胶囊）。一个月后，腹部及盆腔计算机断层扫描显示直径约38 mm的低密度灶、盆腔内肠系膜脂肪平面模糊及盆腔积液。超声显示左侧卵巢区域有一5.2 cm×3.0 cm×4.2 cm的混合回声密度区，盆腔内有一深度为2.0 cm的无回声液性暗区。在腹腔镜下行左侧卵巢囊肿切除术、子宫内膜异位病灶电灼术、子宫肌瘤切除术及盆腔粘连松解术。术后诊断为左侧卵巢巧克力囊肿破裂及子宫内膜异位症（III期，卵巢型，腹膜型）。
腹腔镜手术可安全控制子宫内膜异位症的症状并有效根除该病。
