摘要
子宫附腔畸形(accessory cavitated uterine malformation,ACUM)是一种罕见的苗勒管畸形,其主要临床表现为从初潮开始进行性加重的痛经,需与囊性子宫腺肌病、子宫肌瘤囊性变及其他相关的阻塞性苗勒管畸形相鉴别。手术是其主要治疗方案。报告1例青少年女性患者,痛经渐进加重,伴恶心呕吐,左髂窝痛,需服止痛药。2022年8月盆腔三维超声示:宫腔形态基本正常,子宫左侧壁不均质结节回声28 mm×26 mm×20 mm,内见内膜回声11 mm×10 mm×7 mm,疑囊性局灶性子宫腺肌病或ACUM,行腹腔镜探查术,见子宫外观正常,其左前壁、圆韧带前下方稍饱满,于饱满处切开肌壁,见一组织较苍白,质韧的包块,完整切除送检,经病理确诊为ACUM。随访术后症状消失。
Accessory cavitated uterine malformation(ACUM)is a rare form of Müllerian anomaly,usually presents with progressive and aggravating dysmenorrhea from menarche.It should be distinguished from cystic adenomyoma,degenerating cystic leiomyoma and the other form of obstructive Müllerian anomaly.Surgery is its main treatment option.In this study,we present an adolescent female with progressive worsening dysmenorrhea,nausea and vomiting,pain in the left iliac fossa and need to take painkillers.In August 2022,three-dimensional pelvic ultrasound in our hospital showed:basic normal uterine cavity shape,left side wall heterogeneity nodular echo 28 mm×26 mm×20 mm with endometrial echo within 11 mm×10 mm×7 mm,suspected cystic focal uterine adenomyosis or ACUM.Laparoscopic exploration was performed.The appearance of the uterus was normal,the left anterior wall and at the anterior and inferior part of round ligament were slightly full.The uterine wall of slightly full was resected,a pale and tough masses were found and resected completely for examination.ACUM was confirmed by pathology.Symptoms disappeared after follow-up surgery.
作者
苏丹
李斯静
黄晓武
夏恩兰
SU Dan;LI Si-jing;HUANG Xiaowu;XIA En-lan(Hysteroscopy Center,Fu Xing Hospital,Capital Medical University,Beijing 100038,China)
出处
《国际妇产科学杂志》
CAS
2023年第3期266-270,共5页
Journal of International Obstetrics and Gynecology
关键词
子宫附腔畸形
子宫
先天畸形
苗勒管
痛经
病例报告
Accessory cavitated uterine malformation
Uterus
Congenital abnormalities
Mullerian ducts
Dysmenorrhea
Case reports
