国际妇产科学杂志 ›› 2023, Vol. 50 ›› Issue (4): 382-386.doi: 10.12280/gjfckx.20220841

• 妇科肿瘤研究:病例报告 • 上一篇    下一篇

绝经后重度下腹痛发现子宫内膜癌一例及绝经后腹痛相关疾病文献复习

唐抑澜, 楼姣英()   

  1. 100029 北京中医药大学(唐抑澜);北京中医药大学东方医院(楼姣英)
  • 收稿日期:2022-10-16 出版日期:2023-08-15 发布日期:2023-08-15
  • 通讯作者: 楼姣英,E-mail:doctorlou@126.com
  • 基金资助:
    北京市自然科学基金(7212175)

A Case of Endometrial Cancer Found in Postmenopausal Severe Lower Abdominal Pain and Literature Review of Postmenopausal Abdominal Pain Related Diseases

TANG Yi-lan, LOU Jiao-ying()   

  1. Beijing University of Chinese Medicine, Beijing 100029, China (TANG Yi-lan); Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China (LOU Jiao-ying)
  • Received:2022-10-16 Published:2023-08-15 Online:2023-08-15
  • Contact: LOU Jiao-ying, E-mail: doctorlou@126.com

摘要:

绝经后重度腹痛常见于子宫内膜癌、卵巢癌和宫颈癌晚期,少见于子宫腺肌病恶变、子宫内膜异位囊肿恶变、胃肠道间质瘤(gastrointestinal stromal tumor,GIST)和子宫内膜结核。几乎上述所有疾病的诊断金标准都是病理检查,影像学检查可作为参考辅助诊断,当患者无典型临床症状或B超和磁共振成像无典型影像学特征时,影像学结论会影响医生的诊断,从而延误治疗。通过分析1例子宫腺肌病患者出现绝经后腹痛,无明显内膜增厚、宫腔积液、阴道出血等典型临床表现,术后诊断为ⅢC期子宫内膜浆液性癌患者的临床资料,复习引起绝经后腹痛相关疾病的文献,探讨以绝经后反复腹痛为临床表现患者的诊断策略,防止误诊误治。

关键词: 绝经后期, 腹痛, 少见病, 诊断, 诊断, 鉴别, 病例报告

Abstract:

Severe post-menopausal abdominal pain is commonly seen in advanced endometrial cancer, ovarian cancer and cervical cancer, but rare in malignant transformation of adenomyosis, endometriotic cysts, gastrointestinal stromal tumors (GIST), and endometrial tuberculosis. The gold standard for the diagnosis of almost all of the above-mentioned diseases is pathological examination, and imaging examination can serve as a reference and auxiliary diagnosis. When patients do not have typical clinical symptoms or B-ultrasonography and magnetic resonance imaging do not have typical imaging features, the imaging findings may influence the doctor′s diagnosis and delay treatment. A adenomyosis patient presented with post-menopausal abdominal pain without typical clinical manifestations such as endometrial thickening, hydrops of uterus and vaginal bleeding, the clinical data of the patient with stage ⅢC endometrial serous carcinoma diagnosed after operation were analysed, and the related literatures about post-menopausal abdominal pain related diseases were reviewed, and the diagnostic strategies of the patients with recurrent abdominal pain after menopause were discussed, in order to prevent misdiagnosis and mistreatment.

Key words: Postmenopause, Abdominal pain, Rare diseases, Diagnosis, Diagnosis, differential, Case reports