国际妇产科学杂志 ›› 2019, Vol. 46 ›› Issue (5): 549-551.

• 病例报告 • 上一篇    下一篇

宫颈子宫内膜异位症伴活动性阴道出血一例并文献复习

许阡,段华,金佟,臧春逸   

  1. 100006 北京,首都医科大学附属北京妇产医院妇科微创中心
  • 收稿日期:2019-04-15 修回日期:2019-06-21 出版日期:2019-10-15 发布日期:2019-10-21
  • 通讯作者: 段华,E-mail:duanhuasci@163.com E-mail:duanhuasci@163.com
  • 基金资助:
    国家自然科学基金(81571412)

Acute Vaginal Bleeding Caused by Cervical Endometriosis: A Case Report and Literature Review

XU Qian, DUAN Hua, JIN Tong, ZANG Chun-yi   

  1. Gynecologic Minimally Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China
  • Received:2019-04-15 Revised:2019-06-21 Published:2019-10-15 Online:2019-10-21
  • Contact: DUAN Hua,E-mail:duanhuasci@163.com E-mail:duanhuasci@163.com
  • Supported by:
     

摘要: 宫颈子宫内膜异位症为特殊类型子宫内膜异位症,其伴活动性阴道出血症状,国内外多为个案报道。本文介绍了1例急诊就诊患者,月经干净后第2日出现活动性阴道出血。患者孕3产0,阴道出血量为月经量4~5倍,超声提示宫颈处膨大,给予催产素治疗后血止。住院行双侧子宫动脉栓塞后,行宫腔镜检查提示宫颈管8点处憩室样囊腔,内含大量陈旧血迹,遂行宫腔镜切除、电凝囊腔,术后病理提示宫颈子宫内膜异位囊肿。2年后复查宫腔镜,提示原宫颈病灶囊腔处可见缺损,囊壁可见瘢痕修复,术后随访至今无复发。文献复习宫颈子宫内膜异位囊肿发病机制、临床表现、诊断、治疗,并最后总结该病例经验教训。

关键词: 宫颈疾病, 子宫内膜异位症, 出血, 病例报告

Abstract: Cervical endometriosis is a special type of endometriosis associated with active vaginal bleeding, which has been reported in many cases at home and abroad. In this case, a 40-year-old nulliparous woman, G3P0, visited to emergency room with massive vaginal hemorrhage on the second day after menstruation. The volume of vaginal hemorrhage is 4 to 5 times of normal menstruation. Ultrasound revealed dilatation of the cervix. The bleeding stopped after treatment with oxytocin. After bilateral uterine artery embolization in hospital, the hysteroscopy revealed a large amount of old blood in the diverticulum-like cystic space at 8 o′clock in the cervical canal. Then, hysterscopic resection and electrocoagulation of the cystic space were performed. Postoperative pathology revealed a cervical endometriosis cyst. The second hysteroscopy was performed in 2 years later and showed a defect the cavity of the original cervical lesion and scar repair in the wall of the cyst. There was no recurrence in the follow-up so far. This article reviews the literature on the pathogenesis, clinical presentation, diagnosis, and treatment of endometriosis cyst of the cervix, and concludes with lessons learned from this case.

Key words: Uterine cervical diseases, Endometriosis, Hemorrhage, Case reports

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