以排便困难为首发症状的阴道斜隔综合征1例报告

Ting Wang, L. Zong, J. Zhong, K. Chen
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引用次数: 1

摘要

阴道斜隔综合征(OVSS)是一种罕见的先天性疾病,其特征是子宫畸形、半阴道隔和单侧肾发育不全。不同患者的临床特征不同。在此,我们报告一例以排便困难为首发症状的OVSS,并通过超声和腹腔镜检查进行诊断。这名13岁的女孩以排便困难1个多月,排尿困难6天入住我院。超声检查显示左肾未见,右肾代偿性增大。盆腔见巨大囊性实性肿块(110 mm × 96 mm × 87 mm)。腹腔镜下发现腹腔内有一巨大肿块。表面类似于子宫的血清肌层。肿瘤两侧可见子宫器官,输卵管与卵巢相连。右侧子宫大小约3cm × 2cm。右输卵管和卵巢外观正常。左侧子宫增大(约6cm × 5cm)。左侧输卵管肿大,含有大量棕色血渍,可见血渍从伞端流出。随后行宫腔镜切开修复手术。大多数OVSS患者表现为痛经、腹痛、盆腔肿块和恶臭的粘液脓性分泌物,而本病例的首发症状为排便困难。因此,本病例报告提供了支持该疾病异质性的证据。
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A Case Report of Oblique Vaginal Septum Syndrome with Difficulty in Defecation as the Initial Symptom
Oblique vaginal septum syndrome (OVSS) is a rare congenital disorder characterized by uterus didelphys, hemivaginal septum, and unilateral renal agenesis. Its clinical characteristics vary among different patients. Herein we report a case of OVSS with difficulty in defecation as the initial symptom and diagnosed with ultrasound and laparoscopic exploration. This 13-year-old girl was admitted to our hospital with the complaint of difficulty in defecation for more than 1 month and difficulty in urination for 6 days. Her ultrasound test showed that the left kidney was not displayed, and the right kidney was compensatory enlargement. A giant cystic-solid mass (110 mm × 96 mm × 87 mm) was seen in the pelvic cavity. Under laparoscopy, a huge mass was seen in the abdominal cavity. The surface resembled the seromuscular layer of the uterus. A uterine organ was seen on both sides of the tumor, and both fallopian tubes and ovaries were connected. The size of the right uterus was about 3 cm × 2 cm. The right fallopian tube and ovary were normal in appearance. The left uterus was enlarged (about 6 cm x 5 cm). The left fallopian tube was enlarged and contained a large amount of brown blood stains, and blood stains were seen flowing out from the umbrella end. The hysteroscopic incision and repair surgery were then performed. Most patients with OVSS presented with dysmenorrhea, abdominal pain, pelvic mass, and foul mucopurulent discharge, while in this case, difficulty in defecation was the initial symptom. Thus, this case report provided evidence supporting the heterogeneity of this disorder.
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