The ultrasound diagnosis of gynecologic severe case and analysis of sonogram echogram / 中华医学超声杂志（电子版）

ABSTRACT

Objective To analyze the ultrasonic features of gynecological emergency and severe cases.Methods To analyze 431 cases in clinical,ultrasonic images and examination data of gynecological emergency and severe patients in Peking University Third Hospital from September 2014 to September 2015,and to study clinical pathological and ultrasonic imaging examination.Results In 431 severe cases of gynecologic emergency,the clinical symptom were shown as acute abdominal pain or and vaginal bleeding.They were divided into seven types by clinical examination,operation or conservative treatment under dynamic observation.There were 137 cases of fracture disease,accounting for 31.8％,with corpus luteum rupture in 67 cases,ectopic pregnancy burst in 59 cases and tumor rupture in 11 cases.There were 114 cases of pelvic inflammatory disease,accounting for 26.5％,with hemorrhagic disease of department of gynaecology in 67 cases (15.5％),dysfunctional uterine bleeding in 39 cases,cervical cancer in 11 cases,submucosal myoma in 7 cases,endometrial carcinoma in 6 cases,carcinosarcoma in 4 cases.There were 58 cases of early pregnancy related diseases,accounting for 13.5％.Among them,32 cases were incomplete abortion,and 21 cases were inevitable abortion and 5 cases were hydatidiform mole.Forty-six cases were torsion of pedicle (10.6％).Five cases were genital tract malformation,accounting for 1.2％,with vaginal septum obliquumevery 4 cases and cervical atresia in one case.There were damages after the operation in 4 cases (0.9％),uterus perforation in 2 cases,abdominal wall hematoma in 1 case after cesarean section,and false aneurysm in 1 case after cesarean section.In the 431 cases,there was emergency surgery oroperation after symptomatic treatment in 329 cases,interventional treatment in one case and non-operative treatment in 101 cases.Conclusions There are corresponding typical ultrasonographic characteristics in different diseases of emergency and severe gynaecologic cases,combined with clinical symptoms and medical history.The right diagnosis can be made.Therefore,there are important clinical values of ultrasound in the treatment of emergency and severe gynecologic cases.