附件自发性自截
Spontaneous Autoamputation of Adnexa.
机构信息
Department of Obstetrics and Gynecology, University of Illinois College of Medicine, Peoria, Illinois. (Ms. Banoub and Drs. Konrath, Khan, and Elkattah).
Division of Research Services, University of Illinois College of Medicine; Peoria, Illinois. (Dr. Khan).
出版信息
CRSLS. 2024 Oct 22;11(3). doi: 10.4293/CRSLS.2024.00025. eCollection 2024 Jul-Sep.
INTRODUCTION
Acquired ovarian torsion is an uncommon gynecologic emergency that afflicts women of reproductive age and requires correction by surgery. A rare complication of asymptomatic ovarian torsion can be necrosis and autoamputation of the adnexal structures.
CASE DESCRIPTION
A 28-year-old nulliparous woman presented with irregular menses since puberty associated with dysmenorrhea, menorrhagia, and nausea, and that did not improve with trials of oral hormone therapy. Ultrasound and pelvic MRI revealed a large, tubular-cystic mass separated from the right ovary and tubo-ovarian junction. Intraoperative findings revealed filmy adhesions and fimbriae emanating from this cystic lesion, as well as dilation of the medial portion of the right fallopian tube. Histopathology reported dilated, cystic structures with focal tubal-type epithelial lining, and a dilated fallopian tube lumen, consistent with hydrosalpinx.
DISCUSSION
Autoamputation of fallopian tube is a rare but serious complication of adnexal torsion that should be treated promptly via intraoperative detorsion.
简介
获得性卵巢扭转是一种罕见的妇科急症，影响育龄妇女，需要手术纠正。无症状卵巢扭转的罕见并发症可能是附件结构的坏死和自动截肢。
病例描述
一位 28 岁的未婚妇女自青春期以来出现不规则月经，伴有痛经、月经过多和恶心，口服激素治疗也未见改善。超声和盆腔 MRI 显示一个大的管状囊性肿块与右侧卵巢和输卵管卵巢连接处分离。术中发现该囊性病变有薄膜状粘连和输卵管纤毛，以及右侧输卵管中段扩张。组织病理学报告显示扩张的囊性结构，具有局灶性输卵管型上皮衬里，以及扩张的输卵管管腔，符合输卵管积水。
讨论
输卵管自动截肢是附件扭转的一种罕见但严重的并发症，应通过术中复位及时治疗。
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