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一名中年女性因使用环形子宫托导致阴道残端裂开和小肠脱垂

Vaginal Cuff Dehiscence and Small Intestinal Prolapse in a Middle-Aged Woman Due to Ring Pessary Use.

作者信息

Meng Ran, Fang Zheng, Fu Jing, Cai Qiaoyun, Shen Yingli, Hu Yuru, Li Rongyao, Peng Cheng

机构信息

Graduate School of Anhui Medical University, Hefei, Anhui, 23000, People's Republic of China.

Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People's Republic of China.

出版信息

Int J Womens Health. 2024 Nov 28;16:2025-2031. doi: 10.2147/IJWH.S484688. eCollection 2024.

Abstract

OBJECTIVE

Vaginal cuff rupture is a rare but serious postoperative complication predominantly occurring after hysterectomy. Given that it can lead to partial or total evisceration, bowel strangulation, sepsis, and acute mesenteric ischemia. Any instance of this complication should be treated as a surgical emergency. In this context, we report a case of a vaginal stump following regular use of pessaries.

CASE REPORT

A 50-year-old woman was admitted to the hospital with sudden onset of bowel-like prolapse from the vagina. She had a 7-year history of vaginal prolapse and had previously undergone repair surgery and laparoscopic hysterectomy for uterine fibroids. Following her hysterectomy, she began using a pessary due to recurrent prolapse. Clinical assessment revealed vaginal evisceration of the intestines, necessitating emergency surgery. She was discharged smoothly on the eighth day post-operation. Three months later, she underwent a laparoscopic sacrocolpopexy.

CONCLUSION

The utilization of pessaries may heighten the risk of stump rupture in patients following hysterectomy, thereby demanding more vigilant attention from gynecologists.

摘要

目的

阴道残端破裂是一种罕见但严重的术后并发症,主要发生在子宫切除术后。鉴于其可导致部分或全部脏器脱出、肠绞窄、败血症和急性肠系膜缺血。该并发症的任何病例均应作为外科急症处理。在此背景下,我们报告一例在常规使用子宫托后发生阴道残端破裂的病例。

病例报告

一名50岁女性因突然从阴道脱出类似肠管的组织入院。她有7年阴道脱垂病史,此前因子宫肌瘤接受过修复手术和腹腔镜子宫切除术。子宫切除术后,由于复发脱垂她开始使用子宫托。临床评估显示肠道脏器脱出至阴道,需进行急诊手术。术后第8天她顺利出院。3个月后,她接受了腹腔镜骶骨阴道固定术。

结论

子宫托的使用可能会增加子宫切除术后患者残端破裂的风险,因此妇科医生需要更加警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d12/11611743/6e3c041c63de/IJWH-16-2025-g0001.jpg

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