EMERGENCY SURGICAL TREATMENT OF A VAGINALLY PROLAPSED SUBMUCOUS LEIMYOMA PRESENTING WITH LIFE-THREATENING VAGINAL HEMORRHAGE

Yıl 2013, Cilt: 10 Sayı: 40, 1665 - 1667, 01.10.2013

Eralp Başer Selçuk Erkılınç Emre Özgü Tayfun Güngör

Öz

Aim: Uterine leiomyomata are benign smooth muscle tumors that are encountered commonly in women, especially after the beginning of the reproductive period. Symptoms and findings are usually associated with the location of the leiomyoma within the uterus. Vaginally prolapsed submucous leiomyomas may be completely asymptomatic, or may present with symptoms such as vaginal bleeding, discharge or pelvic pain. In this report, we present a rare case of a vaginally prolapsed submucous uterine leiomyoma that caused hemorrhagic shock, and discuss its emergency surgical treatment.

Anahtar Kelimeler

leiomyoma, vaginally prolapsed, vaginal bleeding, emergency hysterectomy

HAYATI TEHDİT EDEN VAJİNAL KANAMA İLE PREZENTE OLAN VAJENE DOĞMUŞ SUBMÜKÖZ MYOMUN ACİL CERRAHİ TEDAVİSİ

Öz

Amaç: Uterin myomlar kadınlarda özellikle reprodüktif çağın başlamasıyla birlikte sıkça görülen benign düz kas tümörleridir. Semptom ve bulgular genellikle myomun uterus içerisindeki yerleşim yeri ile ilişkilidir. Vajene doğmuş submüköz myomlar tamamen asemptomatik olabildikleri gibi, vajinal kanama, akıntı veya pelvik ağrı ile karşımıza çıkabilirler. Bu yazıda, vajene doğmuş submüköz uterin myoma bağlı meydana gelen hemorajik şok olgusu sunulmuş ve olgunun acil cerrahi tedavisi ele alınmıştır.

Anahtar Kelimeler

myom, vajene doğmuş, vajinal kanama, acil histerektomi

Kaynakça

• Fontarensky M, Cassagnes L, Bouchet P, Azuar AS, Boyer L, Chabrot P. Acute complications of benign uterine leiomyomas: Treatment of intraperitoneal haemorrhage by embolisation of the uterine arteries. Diagn Interv Imaging. 2013 Sep;94(9):885-90. doi: 10.1016/j.diii.2013.01.021
• Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003 Jan;188(1):100-7.
• Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril 2007 Apr;87(4):725-36.
• Vercellini P, Vendola N, Ragni G, Trespidi L, Oldani S, Crosignani PG. Abnormal uterine bleeding associated with iron-deficiency anemia. Etiology and role of hysteroscopy. J Reprod Med 1993 Jul;38(7):502-4.
• Dicker D, Feldberg D, Dekel A, Yeshaya A, Samuel N, Goldman JA. The management of prolapsed submucous fibroids. Aust N Z J Obstet Gynaecol 1986 Nov;26(4):308-11.
• Kim JW, Lee CH, Kim KA, Park CM. Spontaneous prolapse of pedunculated uterine submucosal leiomyoma: usefulness of broccoli sign on CT and MR imaging. Clin Imaging 2008 May-Jun;32(3):233-5.
• McCluggage WG, Alderdice JM, Walsh MY. Polypoid uterine lesions mimicking endometrial stromal sarcoma. J Clin Pathol 1999 Jul;52(7):543-6.
• Chang A, Natarajan S. Polypoid endometriosis. Arch Pathol Lab Med. 2001 Sep;125(9):1257. 9. Gleich P. Transcervical resection of uterine myomas with a resectoscope. Urol Clin North Am 1990 Feb;17(1):59-62.
• Lefebvre G, Vilos G, Allaire C, Jeffrey J, Arneja J, Birch C, et al. The management of uterine leiomyomas. J Obstet Gynaecol Can 2003 May;25(5):396-418; quiz 419-22.
• Camanni M, Bonino L, Delpiano EM, Ferrero B, Migliaretti G, Deltetto F. Hysteroscopic management of large symptomatic submucous uterine myomas. J Minim Invasive Gynecol 2010 Jan-Feb;17(1):59-65. doi: 10.1016/j. jmig.2009.10.013.
• Golan A, Zachalka N, Lurie S, Sagiv R, Glezerman M. Vaginal removal of prolapsed pedunculated submucous myoma: a short, simple, and definitive procedure with minimal morbidity. Arch Gynecol Obstet 2005 Jan;271(1): 11-3. Epub 2004 Mar 4.