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非妊娠女性子宫扭转导致无症状性宫颈切断术

Asymptomatic Cervical Amputation Caused by Uterine Torsion in a Non-Gravid Woman.

作者信息

Stefanović Milan, Vukomanović Predrag, Kutlešić Ranko, Trenkić Milan, Dimitrov Vanja, Stefanović Aleksa

机构信息

Faculty of Medicine, University of Niš, Blvd. Dr Zorana Đinđića 81, 18000 Niš, Serbia.

Gynecolocgy and Obstetrics Clinic, Clinical Center Niš, Blvd. Dr Zorana Đinđića 48, 18000 Niš, Serbia.

出版信息

J Clin Med. 2024 Dec 3;13(23):7356. doi: 10.3390/jcm13237356.

Abstract

Uterine torsion represents a rare condition that may occur during pregnancy or in non-gravid women. This condition is difficult to diagnose, since there are no specific signs besides abdominal pain. Thus, most of the cases are not diagnosed correctly before a surgical procedure and may result in complications and poor outcomes. : We present the first case of uterine torsion of 1080 degrees counterclockwise, with asymptomatic cervical amputation. The intraoperative finding was a uterus that was twisted 1080 degrees around its longitudinal axis, a large fibroid > 15 cm, a large ovarian tumor > 15 cm, and a missing cervix. Upon further inspection, the cervix was found, completely separated from the body of the uterus. After the surgery, the patient remained stable, and her postoperative course was uneventful. She was discharged on the eighth postoperative day. No complications were detected 2 months after the surgery. This specific case is extremely unique, being the only one in searched literature with a 1080° torsion and an amputated cervix. Uterine torsion, especially in postmenopausal women, is a highly rare condition and is difficult to diagnose, with potentially serious outcomes. Any doubts should be assessed as quickly as possible and be dealt with appropriately. If possible, MRI and CT scans could be of great help in differential diagnosis.

摘要

子宫扭转是一种罕见的情况,可发生在孕期或非妊娠女性中。这种情况很难诊断,因为除腹痛外没有其他特异性体征。因此,大多数病例在手术前未能得到正确诊断,可能导致并发症和不良后果。我们报告首例逆时针扭转1080度的子宫扭转病例,伴有无症状的宫颈截断。术中发现子宫绕其纵轴扭转1080度,一个直径大于15厘米的大肌瘤,一个直径大于15厘米的大卵巢肿瘤,且宫颈缺失。进一步检查发现宫颈已完全与子宫体分离。术后患者情况稳定,术后恢复过程顺利。术后第八天出院。术后两个月未发现并发症。这一特殊病例极为独特,是检索文献中唯一一例扭转1080度且宫颈截断的病例。子宫扭转,尤其是在绝经后女性中,是一种极为罕见的情况,难以诊断,可能产生严重后果。任何疑问都应尽快评估并妥善处理。如有可能,磁共振成像(MRI)和计算机断层扫描(CT)对鉴别诊断有很大帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dcb/11642678/6703d1189775/jcm-13-07356-g001.jpg

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