Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA.
Department of Medicine, Michigan State University College of Human Medicine, East Lansing, MI, USA.
Am J Case Rep. 2024 Nov 28;25:e944892. doi: 10.12659/AJCR.944892.
BACKGROUND Hysterectomy is a gynecological procedure that can lead to complications arising from structural changes incurred during the surgical process. Vaginal nodules may appear at the vaginal cuff after hysterectomy, which could be indicative of recurring cancer, endometriosis, or formation of fistulae or granulation tissue. In rare instances, abdominal organ prolapse occurs after vaginal cuff dehiscence. Prolapse of the terminal ileum is the most common type of prolapse from vaginal cuff dehiscence, but prolapsed epiploica of colon after hysterectomy occurs in rare instances. Epiploic appendages are a type of fatty tissue attached to the colonic surface that can become inflamed or necrotic and detach from the colon. The purpose of this report is to describe a rare case of prolapsed epiploica of colon at the vaginal cuff. CASE REPORT A 55-year-old woman who had robot-assisted laparoscopic hysterectomy for endometrioid carcinoma presented with a vaginal polyp 2 months after surgery. Histological analysis of the excised polyp revealed adipose tissue with fat necrosis and calcification, indicative of prolapsed epiploica of colon. This is the first report of post-hysterectomy epiploica of colon at the vaginal cuff not associated with obvious dehiscence. CONCLUSIONS This case highlights the importance of thorough histological analysis of excised vaginal nodules and consideration of prolapsed epiploica of colon in the differential diagnoses in addition to benign and malignant vaginal neoplasms.
子宫切除术是一种妇科手术，可能会导致手术过程中发生的结构变化引起的并发症。子宫切除术后阴道袖口可能会出现阴道结节，这可能表明癌症复发、子宫内膜异位症、瘘管形成或肉芽组织形成。在罕见情况下，阴道袖口裂开后会发生腹部器官脱垂。末端回肠脱垂是阴道袖口裂开后最常见的脱垂类型，但在罕见情况下，结肠带蒂大网膜也会脱垂。网膜附属物是附着在结肠表面的一种脂肪组织，可发生炎症或坏死，并从结肠上脱落。本报告的目的是描述一例罕见的结肠带蒂大网膜在阴道袖口脱垂的病例。病例报告：一名 55 岁女性因子宫内膜样癌行机器人辅助腹腔镜子宫切除术，术后 2 个月出现阴道息肉。切除息肉的组织学分析显示脂肪组织伴脂肪坏死和钙化，提示为结肠带蒂大网膜脱垂。这是首例与明显裂开无关的子宫切除术后阴道袖口结肠带蒂大网膜脱垂的报道。结论：本例强调了对切除的阴道结节进行彻底的组织学分析的重要性，并在鉴别诊断中除了良性和恶性阴道肿瘤外，还应考虑结肠带蒂大网膜脱垂。
