Diagnóstico y tratamiento de hematosalpinx y hematometra en una paciente con hemiútero con cavidad rudimentaria no comunicante. Reporte de un caso y revisión de la bibliografía.

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    • Alternate Title:
      Diagnosis and management of hematosalpinx and hematometra in a patient with a hemiuterus and rudimentary uterine hemicavity noncommunicating. Case report and review of literature.
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    • Abstract:
      BACKGROUND: Congenital malformations of the female genital tract have an overall prevalence of approximately 3% and the origin is due to an alteration in the embryological development of the Müllerian ducts. The hemi-uterus with a rudimentary cavity has a prevalence of only 0.1% CASE REPORT: 29-year-old patient was admitted to emergency department with a 3-month severe dysmenorrhea associated with irregular menstrual cycles, without reporting improvement with oral analgesia and oral contraceptive. She had no medicalsurgical history of interest or previous sexual relations. During the study using 2D ultrasound and pelvic computed tomography, a congenital uterine malformation was observed, corresponding to a hemi-uterus with a rudimentary non-communicating cavity and a retention content compatible with a 55x48mm hematometra and another elongated and angled cystic structure with 65x21mm echogenic content suggestive of hematosalpinx. Treatment with GnRH analogues was prescribed until surgery was performed. Finally, laparoscopic excision of the rudimentary cavity and the ipsilateral left tube was performed. The postoperative evolution was satisfactory. Currentlythe patient is asymptomatic. CONCLUSIONS: In the study of uterine malformations, the pertinent imaging tests must be included in order to establish correct surgical management. When a hemi-uterus with a rudimentary cavity is diagnosed, a laparoscopy should always be performed to remove both the rudimentary cavity and the ipsilateral uterine tube to avoid short and long-term obstetric-gynecological complications. [ABSTRACT FROM AUTHOR]
    • Abstract:
      ANTECEDENTES: Las malformaciones congénitas del aparato genital femenino suponen una prevalencia global de 3% y su origen se debe a una alteración en los conductos de Müller durante el desarrollo embrionario. La incidencia de hemiútero con cavidad rudimentaria es de 0.1%. CASO CLÍNICO: Paciente de 29 años, que acudió al servicio de Urgencias por dismenorrea intensa relacionada con ciclos menstruales irregulares de tres meses de evolución, sin disminución de los síntomas incluso con analgésicos orales. La ecografía 2D y la tomografía pélvica reportaron: malformación uterina congénita correspondiente a hemiútero con cavidad rudimentaria no comunicante y contenido compatible con hematometra, de 55 x 48 mm; también se observó otra estructura quística alargada y en forma de codo, con contenido ecogénico de 65 x 21 mm, sugerente de hematosalpinx. Se indicaron análogos de la GnRH hasta la cirugía. Se resecaron la cavidad rudimentaria y la trompa izquierda ipsilateral por vía laparoscópica. El posoperatorio cursó sin contratiempos. En la actualidad la paciente permanece en óptimas condiciones de salud. CONCLUSIONES: El estudio de las malformaciones uterinas debe incluir técnicas de imagen para establecer el tratamiento quirúrgico adecuado. En pacientes con hemiútero, con cavidad rudimentaria, debe efectuarse una laparoscopia, con la intención de extirpar la cavidad rudimentaria y la trompa uterina ipsilateral para evitar complicaciones ginecoobstétricas a corto y largo plazo. [ABSTRACT FROM AUTHOR]
    • Abstract:
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