深度浸潤型子宮內膜異位症造成延遲性產後大出血之個案報告

Deep infiltrating endometriosis (DIE) related left uterine laceration causing severe post-partum hemorrhage: a case report and literature review

陳冠宇(Kuan-Yu Chen) ； 洪煥程(Huann-Cheng Horng) ； 陳晟立(Cheng-Li Chen) ； 葉長青(Chang-Ching Yeh)

《婦癌醫學期刊》 52期 (2020/10) Pp. 16-20

摘要

在懷孕過程中因子宮內膜異位症造成自發性腹內出血相對少見，但通常是危及生命的嚴重併發症。在此介紹一個於真空吸引輔助陰道分娩後6天發現嚴重腹內出血的病例。此病例於剖腹探查時發現：子宮左後壁缺損伴隨左側子宮動脈活動性出血，周圍組織碎裂且易於出血。在打開後腹膜並分離輸尿管以後，我們進行了左側子宮動脈阻斷手術以減緩出血。術後病例切片顯示為子宮內膜異位組織且無蛻膜化蛻變。

關鍵字

懷孕 ； 子宮內膜異位症 ； 深度浸潤型子宮內膜異位症 ； 腹腔積血 ； 產後大出血

並列摘要

Complication of spontaneous hemoperitoneum related to endometriosis during pregnancy are rare but usually represent life-threatening conditions. We presented a case that suffered from massive hemoperitoneum 6 days after vacuum assisted vaginal delivery. Within exploratory laparotomy, left posterior uterine wall defect with left uterine artery active bleeding were noted. Surrounding tissue was fragile and easily touch-bleeding. After open the retroperitoneum and separated the ureter, we performed the left uterine artery ligation. Pathology of fragile tissue showed compatible with endometriosis without decidual change.

並列關鍵字

pregnancy ； endometriosis ； deep infiltrated endometriosis ； hemoperitoneum ； post-partum hemorrhage