关键词: 子宫切除术, 子宫内膜异位症, 阴道疾病, 诊断,鉴别, 病例报告

Abstract:

Endometriosis (EMs) is a common chronic inflammatory disease in women that refers to the presence of glands and stroma of the endometrium outside the uterine cavity, most commonly in the ovaries, pelvic peritoneal surfaces, or other pelvic tissues. We report a 48-year-old woman who developed vaginal stump endometriosis 15 years after hysterectomy for hysteromyoma. The patient was admitted to the hospital due to irregular vaginal bleeding accompanied by abdominal pain for 3 years and aggravation for 2 months. Enhanced CT of the whole abdomen found irregular soft tissue beside the left iliac vessels. After multidisciplinary consultation, the patient was diagnosed with vaginal stump disease and underwent laparoscopic exploration. Resection of the left vaginal stump mass was performed according to the intraoperative findings, and the excised tissue was confirmed to be EMs by paraffin section pathological examination. Combined with this case, we discussed and reviewed relevant literature to provide diagnosis and treatment ideas for clinical cases of vaginal bleeding after hysterectomy, so as to improve clinicians’ understanding of postoperative vaginal stump EMs.

Key words: Hysterectomy, Endometriosis, Vaginal diseases, Diagnosis, differential, Case reports