Datta Sujata, Basu Ritisha
Department of Obstetrics and Gynaecology, Fortis Anandapur, Kolkata, India.
Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
Womens Health Rep (New Rochelle). 2022 May 2;3(1):473-475. doi: 10.1089/whr.2021.0152. eCollection 2022.
Our case highlights an extreme form of cesarean scar defect with diagnostic and surgical challenges. The unusual presentation of a large extrauterine-encapsulated collection of altered blood and hemosiderin behind the posterior bladder wall that communicated with the endometrial cavity, through a full thickness myometrial discontinuity, at the site of a previous cesarean section, mimicked an endometrioma in an unusual location. This case report not only highlights the diagnostic challenge involved in this case but also highlights the surgical steps involved in the laparoscopic management of this extreme end of the spectrum of cesarean scar defects. We have attached a video of the laparoscopic surgery with step-wise description to shed more light on the management of this rare complication.
我们的病例突出了一种剖宫产瘢痕缺损的极端形式,存在诊断和手术挑战。膀胱后壁后方出现大量宫外包裹性陈旧血液和含铁血黄素聚集,通过既往剖宫产部位的全层子宫肌层连续性中断与子宫内膜腔相通,这种不寻常的表现酷似罕见部位的子宫内膜瘤。本病例报告不仅突出了该病例所涉及的诊断挑战,还突出了剖宫产瘢痕缺损这一谱系极端情况的腹腔镜管理所涉及的手术步骤。我们附上了腹腔镜手术视频及逐步描述,以更清楚地说明这种罕见并发症的处理。