Geisler J P, Denman B J, Cudahy T J, Lee T H, Geisler H E
Department of Obstetrics and Gynecology, St. Vincent Hospital and Health Care Center, Indianapolis, Indiana 46260.
Gynecol Oncol. 1994 Jun;53(3):380-1. doi: 10.1006/gyno.1994.1153.
Ovarian carcinoma commonly has an insidious onset. By the time the diagnosis is made, advanced disease is usually present. Rarely does a patient have acute symptoms which require immediate medical attention and lead to the correct diagnosis. A 40-year-old white female presented with lower abdominal pain, nausea, and light-headedness. Physical examination revealed a markedly tender lower abdomen with the right lower quadrant slightly more tender than the left. Hemoglobin level was noted to have decreased 2.6 g/dl over 16 hr. At exploratory laparotomy, 1500 cc of blood and a ruptured right ovarian mass were found. Pathologic analysis revealed a malignant mixed mesodermal tumor of the right ovary and an endometrioma of the left ovary. In conclusion, ovarian carcinoma may present as an acute abdomen because of intra-abdominal hemorrhage. It should be part of the differential diagnosis in a woman with an acute surgical abdomen and a hemoperitoneum.
卵巢癌通常起病隐匿。在确诊时，往往已处于疾病晚期。患者很少出现需要立即就医并能导致正确诊断的急性症状。一名40岁的白人女性出现下腹部疼痛、恶心和头晕症状。体格检查发现下腹部明显压痛，右下腹比左下腹压痛稍重。血红蛋白水平在16小时内下降了2.6 g/dl。在剖腹探查术中，发现1500 cc血液及右侧卵巢肿物破裂。病理分析显示右侧卵巢为恶性混合性中胚叶肿瘤，左侧卵巢为子宫内膜瘤。总之，卵巢癌可能因腹腔内出血而表现为急腹症。对于患有急性外科急腹症和腹腔积血的女性，应将其纳入鉴别诊断范围。
