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báo cáo khoa học: " Chronic nonpuerperal uterine inversion and necrosis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Chronic nonpuerperal uterine inversion and necrosis: a case report | Kilpatrick et al. Journal of Medical Case Reports 2010 4 381 http www.jmedicalcasereports.eom content 4 1 381 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Chronic nonpuerperal uterine inversion and necrosis a case report Charlie C Kilpatrick 1 Lubna Chohan2 Robert C Maier1 Abstract Introduction Inversion of the non-pregnant uterus is rare. Case presentation A 56-year-old African American woman presented to our emergency center with complaints of a mass protruding from her vagina. She subsequently underwent vaginal myomectomy abdominal hysterectomy and bilateral salpingo-oophorectomy. Pathologic examination revealed a necrotic fibroid and endometrium. At the time of laparotomy an inverted uterus was diagnosed when a 3 cm dimple containing bilateral round ligaments infundibulopelvic ligaments and bladder was observed. Conclusion Chronic nonpuerperal inversion of the uterus is rare. Infection should be suspected and appropriate broad spectrum antibiotics begun while planning surgery. An attempt at vaginal restoration and removal is difficult. Abdominal hysterectomy may be necessary taking care to locate the distal urinary collecting system. Introduction Chronic uterine inversion of the nonpuerperal uterus is an uncommon event reported approximately 100 times in the literature since 1940 1 2 . Chronic nonpuerperal uterine inversion is often associated with uterine pathology. Prolapsed fibroids tend to be the most common inciting factor with occasional reports of inversion associated with uterine neoplasm and endometrial polyps 1 3-6 . Three contributing factors proposed for uterine inversion are 1 sudden emptying of the uterus which was previously distended by a tumor 2 thinning of the uterine walls due to an intrauterine tumor and 3 dilatation of the cervix 3 . The following is a case report of a woman who presented hospital with nonpuerperal uterine inversion secondary to a prolapsed necrosing submucous fibroid with accompanying uterine necrosis. .