Sangrado genital por cuerpo extraño en niñas prepuberales: a propósito de un caso / Genital bleeding caused by foreign body in prepubertal girls: a case report

El sangrado genital en niñas prepúberes es un signo poco frecuente y siempre requiere determinar su causa. Se necesitan una detallada anamnesis y examen físico, con el conocimiento adecuado de la anatomía uroginecológica, y, en muchos casos, estudios de imágenes y exámenes complementarios, para arribar al diagnóstico. Se presenta el caso de una niña de 7 años con sangrado genital, cuyo examen físico y estudios complementarios fueron poco concluyentes, y que requirió un procedimiento invasivo para su resolución. (AU)

Genital bleeding in prepubertal girls is a rare sign and always requires determining its cause. A detailed history and physical examination are needed, with adequate knowledge of urogynecological anatomy, and in many cases, imaging studies and complementary tests, to arrive at the diagnosis. We present the case of a 7-year-old girl with genital bleeding, whose physical examination and complementary studies were inconclusive, requiring an invasive procedure for its resolution. (AU)

Radiological findings of uterine arteriovenous malformation: a case report of an unusual and life-threatening cause of abnormal vaginal bleeding / Aspectos radiológicos da malformação arteriovenosa uterina: relato de caso de uma causa incomum e perigosa de sangramento vaginal anormal

Uterine arteriovenous malformations may cause life-threatening abnormal genital bleeding in women at childbearing age. Transvaginal Doppler ultrasonography is a widely available, noninvasive and excellent diagnostic method. The authors report the case of a patient with history of gestational trophoblastic disease and multiple curettage procedures who developed uterine arteriovenous malformations, with remission of the lesions after treatment with methotrexate.

Malformações arteriovenosas uterinas podem causar sangramento genital anormal, representando risco de morte nas mulheres em idade reprodutiva. O ultrassom transvaginal com Doppler é um método não invasivo amplamente disponível e excelente ferramenta diagnóstica. Apresentamos o caso de paciente com história de doença trofoblástica gestacional e múltiplas curetagens que evoluiu com malformações arteriovenosas uterinas, apresentando remissão das lesões após tratamento com metotrexate.

Two Cases of Subchorionic Hematoma Successfully Treated with Tokishakuyakusan / 日本東洋医学雑誌

I report two cases of subchorionic hematoma successfully treated with Tokishakuyakusan. They had genital bleeding due to subchorionic hematoma in the second trimester of pregnancy. I prescribed Tokishakuyakusan, and their genital bleeding improved within a week after the administration. The hematoma disappeared in less than two weeks after the administration, and they delivered infants of 2470g and 3324g respectively at 39 weeks pregnant by vaginal delivery. I found Ketsu stagnation, Sui disturbance and coldness of extremities in two cases. Although several studies suggested that the presence of subchorionic hematoma might be associated with adverse pregnancy outcome, there is no effective treatment for subchorionic hematoma in western medicine. The present cases suggest that Tokishakuyakusan may be useful in the treatment of subchorionic hematoma.