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一名绝经后女性慢性完全性子宫内翻的罕见病例:病例报告及文献综述

A rare case of chronic complete uterine inversion in a postmenopausal woman: a case report and literature review.

作者信息

Hu Jie, Yang Weili, Zhang Fang, Yan Chunhong

机构信息

Department of Gynecology, The Affiliated People's Hospital of Ningbo University, Ningbo, China.

出版信息

J Int Med Res. 2025 Jan;53(1):3000605241311158. doi: 10.1177/03000605241311158.

Abstract

Uterine inversion is a rare condition that refers to the collapse of the fundus into the uterine cavity and occurs in puerperal and non-puerperal conditions. Non-puerperal uterine inversion is particularly infrequent. Diagnosing non-puerperal uterine inversion is often challenging because it resembles vaginal or cervical tumors and pelvic organ prolapse. Furthermore, this condition alters the anatomical structure of pelvic organs, thereby complicating diagnosis and treatment, and potentially leading to misdiagnosis with grave consequences. We report a case of a postmenopausal woman who presented with irregular vaginal bleeding and dysuria for 2 months. Preoperative enhanced pelvic magnetic resonance imaging suggested a benign tumor combined with uterine inversion, which was subsequently confirmed during surgery. A laparoscopic attempt to reposition the uterus failed, leading to successful repositioning via an abdominal incision and subsequent total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination showed a submucosal leiomyoma, which was smaller than that typically reported in other cases. We also conducted a review of previous cases to offer empirical guidance for the diagnosis and treatment of this rare condition.

摘要

子宫内翻是一种罕见的病症,指子宫底部陷入子宫腔,可发生于产褥期和非产褥期情况。非产褥期子宫内翻尤为少见。诊断非产褥期子宫内翻往往具有挑战性,因为它类似阴道或宫颈肿瘤以及盆腔器官脱垂。此外,这种病症会改变盆腔器官的解剖结构,从而使诊断和治疗复杂化,并可能导致误诊,造成严重后果。我们报告一例绝经后女性病例,该患者出现不规则阴道出血和排尿困难2个月。术前增强盆腔磁共振成像提示为良性肿瘤合并子宫内翻,随后在手术中得到证实。腹腔镜尝试复位子宫失败,最终通过腹部切口成功复位,随后进行了全腹子宫切除术及双侧输卵管卵巢切除术。组织病理学检查显示为黏膜下平滑肌瘤,其大小比其他病例中通常报道的要小。我们还回顾了既往病例,为这种罕见病症的诊断和治疗提供经验指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a86b/11744594/936826b3de85/10.1177_03000605241311158-fig1.jpg

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