14. An Unusual Case of Hematometrocolpos in a Young Patient with Acute Myeloid Leukemia

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology Pub Date : 2025-02-28 DOI:10.1016/j.jpag.2025.01.047

Rabab Isa , Noor Zwayne

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引用次数: 0

Abstract

Background

Hematometra and hematocolpos are uncommon conditions involving fluid accumulation in the uterus and vagina, often due to primary or secondary outflow obstruction. Their occurrence in young patients, particularly those with hematologic disorders, poses diagnostic challenges and can lead to significant morbidity. This case report aims to enhance awareness of acquired hematometrocolpos resulting from graft versus host disease (GvHD) in a post-hematopoietic stem cell transplant patient.

Case

A 17-year-old female with a history of acute myeloid leukemia presented with severe pelvic pain after treatment for cancer, GvHD, and premature ovarian insufficiency. Evaluation revealed significant hematocolpos and a distended uterus to 16 cm. Diagnostic laparoscopy and hysteroscopy identified atrophic vaginal and cervical tissues with substantial adhesions. Approximately 300 cc of dark blood was drained, and a levonorgestrel-releasing intrauterine device was placed. Despite initial improvement, the patient experienced recurrent hematocolpos requiring repeat surgical decompression. She is currently doing well with vaginal estrogen and dilators to maintain patency.

Comments

This case highlights consideration of hematometrocolpos in adolescents with complex medical histories, particularly those undergoing treatment for hematologic malignancies. Early recognition and intervention can prevent long-term complications and improve patient outcomes. Continued education on the implications of GvHD on the female genital tract is essential for optimizing care in this vulnerable population.

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14. 年轻急性髓系白血病患者不寻常的血球性结肠一例

背景：血肿和积血是一种少见的情况，涉及子宫和阴道积液，通常是由于原发性或继发性流出梗阻。它们发生在年轻患者，特别是血液系统疾病患者中，给诊断带来了挑战，并可能导致显著的发病率。本病例报告旨在提高对造血干细胞移植后患者移植物抗宿主病（GvHD）引起的获得性血友病的认识。病例1,17岁女性，有急性髓性白血病病史，因癌症、GvHD和卵巢早衰治疗后出现严重盆腔疼痛。评估显示明显的结肠出血和子宫扩张至16厘米。诊断性腹腔镜和宫腔镜检查发现萎缩的阴道和宫颈组织有大量粘连。排出约300cc的深色血液，放置左炔诺孕酮释放宫内节育器。尽管最初有所改善，但患者经历了反复的结肠出血，需要重复手术减压。她目前使用阴道雌激素和扩张剂维持通畅情况良好。评论：本病例强调了对具有复杂病史的青少年，特别是那些正在接受血液恶性肿瘤治疗的青少年的血液计量性结肠的考虑。早期识别和干预可以预防长期并发症并改善患者预后。继续教育GvHD对女性生殖道的影响对于优化这一弱势群体的护理至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric and adolescent gynecology 医学-妇产科学

CiteScore

3.90

自引率

11.10%

发文量

251

审稿时长

57 days

期刊介绍： Journal of Pediatric and Adolescent Gynecology includes all aspects of clinical and basic science research in pediatric and adolescent gynecology. The Journal draws on expertise from a variety of disciplines including pediatrics, obstetrics and gynecology, reproduction and gynecology, reproductive and pediatric endocrinology, genetics, and molecular biology. The Journal of Pediatric and Adolescent Gynecology features original studies, review articles, book and literature reviews, letters to the editor, and communications in brief. It is an essential resource for the libraries of OB/GYN specialists, as well as pediatricians and primary care physicians.