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子宫穿孔作为宫内操作导致大网膜嵌顿的一种并发症:综述

Uterine Perforation as a Complication of the Intrauterine Procedures Causing Omentum Incarceration: A Review.

作者信息

Zorilă George Lucian, Căpitănescu Răzvan Grigoraș, Drăgușin Roxana Cristina, Istrate-Ofițeru Anca-Maria, Bernad Elena, Dobie Mădălina, Bernad Sandor, Craina Marius, Ceaușu Iuliana, Marinaş Marius Cristian, Comănescu Maria-Cristina, Zorilă Marian Valentin, Drocaș Ileana, Berbecaru Elena Iuliana Anamaria, Iliescu Dominic Gabriel

机构信息

Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania.

Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania.

出版信息

Diagnostics (Basel). 2023 Jan 16;13(2):331. doi: 10.3390/diagnostics13020331.

Abstract

OBJECTIVE

Omentum involvement resulting from uterine perforation is a rare complication following intrauterine procedures that might require immediate intervention due to severe ischemic consequences. This review examines the prevalence of this complication, risk factors, the mode and timing of diagnosis, the proper management and the outcome.

METHODS

A systematic literature search was conducted on PubMed, PubMed Central and Scopus using uterine perforation, D&C, abortion and omentum as keywords. The exclusion criteria included the presence of the uterus or placenta's malignancy and uterine perforation following delivery or caused by an intrauterine device.

RESULTS

The review included 11 articles from 133 screened papers. We identified 12 cases that three evaluators further analysed. We also present the case of a 32-year-old woman diagnosed with uterine perforation and omentum involvement. The patient underwent a hysteroscopic procedure with resectioning the protruding omentum into the uterine cavity, followed by intrauterine device insertion.

CONCLUSION

This paper highlights the importance of a comprehensive gynaecological evaluation following a D&C procedure that includes a thorough clinical examination and a detailed ultrasound assessment. Healthcare providers should not overlook the diagnosis of omentum involvement in the presence of a history of intrauterine procedures.

摘要

目的

子宫穿孔导致大网膜受累是宫内操作后一种罕见的并发症,由于严重的缺血后果可能需要立即干预。本综述探讨了这种并发症的发生率、危险因素、诊断方式和时机、恰当的处理方法及结局。

方法

在PubMed、PubMed Central和Scopus上进行系统的文献检索,使用子宫穿孔、刮宫术、流产和大网膜作为关键词。排除标准包括子宫或胎盘恶性肿瘤的存在以及分娩后或由宫内节育器引起的子宫穿孔。

结果

该综述纳入了从133篇筛选论文中选取的11篇文章。我们确定了12例病例,由三名评估人员进行进一步分析。我们还介绍了一名32岁女性被诊断为子宫穿孔并伴有大网膜受累的病例。该患者接受了宫腔镜手术,将突出至宫腔内的大网膜切除,随后置入宫内节育器。

结论

本文强调了刮宫术后进行全面妇科评估的重要性,包括全面的临床检查和详细的超声评估。医疗保健提供者不应忽视在有宫内操作史的情况下对大网膜受累的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ca0/9858542/e49f1d5c0ffc/diagnostics-13-00331-g001.jpg

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