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宫腔镜联合腹腔镜诊治子宫穿孔继发大网膜嵌顿1例并文献复习

Hysteroscopy combined with laparoscopy in the diagnosis and treatment of omentum majus incarceration secondary to uterine perforation: A case report and literature review.

作者信息

Li Xiaolin, Hu Jiandong, Li Jing, Tao Zhonge, Qu Quanxin, Li Fenge

机构信息

Department of Gynecology, Tianjin First Central Hospital, Tianjin, China.

Core Laboratory, Tianjin Beichen Hospital of Nankai University, Tianjin, China.

出版信息

J Obstet Gynaecol Res. 2025 Jan;51(1):e16213. doi: 10.1111/jog.16213.

Abstract

Cervical dilatation, uterine evacuation, and curettage (D&E&C) are common gynecological procedures for abortion, yet they carry risks of complications such as uterine perforation and intra-abdominal organ incarceration. Here, we report a rare case of a breastfeeding patient who had an embedded abdominal greater omentum in the anterior wall of the uterus and into the uterine cavity during D&E&C. We used combined hysteroscopic and laparoscopic treatment for this case and successfully removed the embedded greater omentum. Our experience underscores the importance of vigilant intraoperative monitoring and prompt management to prevent serious complications like infection and bowel injury. In conclusion, hysteroscopic and laparoscopic combination treatment can be a preferred approach to avoid serious adverse outcomes for uterus perforation patients who developed omentum majus incarceration.

摘要

宫颈扩张、子宫排空及刮宫术(D&E&C)是常见的妇科流产手术,但它们存在子宫穿孔和腹腔内器官嵌顿等并发症风险。在此,我们报告一例罕见病例,一名哺乳期患者在D&E&C手术期间,大网膜嵌入子宫前壁并进入子宫腔。我们对该病例采用宫腔镜和腹腔镜联合治疗,成功移除了嵌入的大网膜。我们的经验强调了术中密切监测和及时处理以预防感染和肠损伤等严重并发症的重要性。总之,对于发生大网膜嵌顿的子宫穿孔患者,宫腔镜和腹腔镜联合治疗可作为避免严重不良后果的首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a7e/11735067/f1a925637250/JOG-51-0-g001.jpg

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