阴道后穹窿侵袭性出血1例

D. Tang, Junling Liu, Ruxia Shi, Yunfen Jiang, Zhongfang Zhang, Jiming Chen
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摘要

深度浸润性子宫内膜异位症(DIE)是指腹膜下存在子宫内膜植入物、纤维化和肌肉增生,浸润组织深度超过5mm。深层子宫内膜异位症的发生频率由高到低依次为子宫骶韧带(USL)、直肠乙状结肠、阴道和膀胱。疼痛和不孕是DIE的主要表现,包括痛经疼痛、慢性盆腔疼痛、性交困难、排便疼痛、排尿困难和背部疼痛。DIE病变浸润深,疼痛症状严重,保守治疗差,手术困难,盆腔粘连,手术附件损伤风险高。子宫内膜异位症一直是妇科腹腔镜手术临床治疗的难点,目前尚无统一的临床分型和治疗规范[3-4]。本文报道一例阴道后穹窿DIE所致复发性阴道出血的特殊病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Special Case Report of Aggressive Hemorrhage in Posterior Vaginal Fornix DIE
Deep infiltrating endometriosis (DIE) is defined by the presence of endometrial implants, fibrosis, and muscular hyperplasia below the peritoneum, invading the tissue to a depth of more than 5 mm [1]. Deep endometriosis involves, in descending order of frequency, the uterosacral ligaments (USL), the rectosigmoid colon, the vagina, and the bladder [2]. Pain and infertility are the main manifestations of DIE, including dysmenorrhea pain, chronic pelvic pain, dyspareunia, defecation pain, dysuria and back pain. DIE lesions are deep infiltration, severe pain symptoms, poor conservative treatment, difficult surgery, pelvic adhesions, and high risk of surgical accessory injury. It has been a difficult point in clinical treatment of endometriosis and gynecological laparoscopic surgery, there is no unified clinical type and treatment specifications [3-4]. This paper reported a special case of recurrent vaginal hemorrhage caused by posterior vaginal fornix DIE.
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