成年女性阴道异物滞留10年一例

doi:10.12280/gjszjk.20220281

摘要/Abstract

摘要：

报告1例28岁女性阴道异物滞留10年的病例。该患者自述10年前有被性侵史，未就医。2年前开始同房出现间断阴道出血，1年前出现腹痛、发热症状，盆腔磁共振成像提示阴道异物可能。本次入院后行宫腹腔镜联合手术，腹腔镜探查见盆腔脏器表面均被覆大量炎性粘连带，双侧输卵管僵硬、迂曲，未见阴道异物突入盆腔，宫腔镜探查示阴道中段大量炎性质硬息肉状赘生物，其间可见直径1 cm孔洞，宫腔镜探入后，可见右侧穹窿部一桶状质硬黑色异物，长约3 cm，直径约2 cm，此异物与穹窿及阴道壁广泛致密粘连，行宫腹腔镜联合阴道异物取出术+宫腔镜下阴道炎性赘生物切除术+阴道修补术，术后恢复良好。

关键词: 异物, 阴道, 宫腔镜检查, 腹腔镜检查, 病例报告, 滞留

Abstract:

To report a case of a 28-year-old woman with a vaginal foreign body retained for 10 years. The patient reported a history of sexual assault 10 years ago and did not seek medical attention afterwards. She started having intercourse 2 years ago, and had vaginal bleeding. She developed abdominal pain and fever 1 year ago. The pelvic magnetic resonance imaging suggested a possible vaginal foreign body. After admission, the combined hysteroscopy and laparoscopic surgery was performed. Laparoscopy showed the surface of the pelvic organs was covered with a large amount of inflammatory adhesions, the tubes were stiff and tortuous bilaterally, and that no vaginal foreign body was protruded into the pelvis. Hysteroscopy showed a large number of hard inflammatory polyp-like superfluous organisms in the middle part of the vagina, with a 1 cm hole between them. After hysteroscopic access, a barrel-shaped hard black foreign body, approximately 3 cm long and 2 cm in diameter, was seen in the right fornix, which was extensively and densely adherented to the fornix and vaginal wall. The foreign body was removed under the hysteroscopy combined hysterolaparoscopy, the inflammatory tissue located in the vagina was resected, and the vagina was repaired. The patient was recovering well after surgery.

Key words: Foreign bodies, Vagina, Hysteroscopy, Laparoscopy, Case reports, Retention

许阡, 成九梅. 成年女性阴道异物滞留10年一例[J]. 国际生殖健康/计划生育, 2022, 41(6): 472-475.

XU Qian, CHENG Jiu-mei. A Case of Vaginal Foreign Body Retained for Ten Years in An Adult[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(6): 472-475.

图/表 4

图1 盆腔MRI图像注：阴道右半穹窿内类长方体状混杂信号，范围约2.4 cm×3.5 cm×2.5 cm，边缘清晰规则。

图2 腹腔镜探查所见注：盆腔脏器表面被覆大量炎性粘连带。

图3 宫腔镜探查所见注：A 阴道中段可见大量炎性质硬息肉样赘生物；B 右侧穹窿部一桶状质硬黑色异物；C 分离异物与周围组织粘连。

图4 台下探查异物注：阴道异物为硬塑料桌角套，长3 cm，直径2 cm，套内可见大量肉芽组织物。

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