Abstract:

In addition to symptoms such as menorrhagia, dysmenorrhea, and infertility, patients with adenomyosis may present with coagulation disorders, a hypercoagulable state, and thrombotic tendency. This article reports a case of adenomyosis complicated by deep vein thrombosis of the lower extremity and pulmonary embolism. The patient presented with abnormal uterine bleeding and lower limb pain. After hemostatic and anticoagulant therapy, she underwent total abdominal hysterectomy. Postoperative pathology confirmed the presence of intravascular microthrombi within the adenomyosis lesions. During the 1.5-year follow-up, the patient's D-dimer levels and carbohydrate antigen 125 levels returned to normal, and ultrasonography of both lower limbs indicated recanalization of the occluded vessels, with no new thrombotic events. This case suggests that patients with adenomyosis exhibit a hypercoagulable and prothrombotic tendency, making them susceptible to thrombotic disorders even in the presence of abnormal bleeding. During diagnosis and treatment, close attention should be paid to the patient’s arterial oxygen saturation and subjective complaints to improve clinical detection. The gradual normalization of coagulation parameters after hysterectomy further indicates a close association between adenomyosis and coagulation dysfunction. Removal of the uterus or adenomyotic lesions may potentially reverse the hypercoagulable state induced by adenomyosis.

Key words: Adenomyosis, Blood coagulation, Venous thromboembolism, Therapy, Prognosis