ABSTRACT
La metrorragia en adolescentes suele ser consecuencia de ciclos anovulatorios característicos de las primeras menstruaciones, los cuales producen episodios de hemorragia uterina disfuncional. Solo en algunas ocasiones subyace una lesión orgánica. Se presenta el caso de una adolescente de 12 años que consulta por menstruaciones abundantes, que se prolongan en el tiempo con anemia ferropénica secundaria. En una ecografía abdominal se objetiva la presencia de una masa anexial derecha compatible bien con endometrioma ovárico, bien con folículo hemorrágico. La persistencia del sangrado más allá de tres o seis meses, desde el momento de la primera consulta, debe ir acompañada de una analítica y un estudio de imagen, en general, una ecografía. Debe valorarse la derivación a Atención Especializada (AU)
Metrorrhagia in teenagers is often caused by anovulatory cycles, characteristic of the firsts menstruations, that produce episodes of dysfunctional uterine bleeding. Only sometimes there is an underlying organic lesion. We present a 12 years old teenager who consulted for heavy bleeding during menstruation that extended in time, with secondary ferropenic anemia. An abdominal ultrasound showed a right adnexal mass compatible with an ovarian endometrioma or a hemorrhagic follicle. The persistence of bleeding beyond 3 to 6 months from the first consultation makes mandatory an abdominal ultrasound and a blood test. The referral to a specialist should be considered (AU)
Subject(s)
Humans , Female , Adolescent , Metrorrhagia/complications , Metrorrhagia/diagnosis , Metrorrhagia/drug therapy , Menstruation Disturbances/complications , Menstruation Disturbances/diagnosis , Menstruation Disturbances/drug therapy , Metrorrhagia/rehabilitation , Metrorrhagia , Follicle Stimulating Hormone, Human/metabolism , Menstruation Disturbances/physiopathology , Menstruation Disturbances , Primary Health Care/methods , Primary Health CareABSTRACT
OBJECTIVE: To describe the outcome of patients with uterine arteriovenous malformations (AVMs) after uterine artery embolization (UAE). DESIGN: Retrospective case series. SETTING: Tertiary center of a university hospital. PATIENT(S): Thirteen patients were referred to a tertiary medical center from primary care facilities with profuse uterine bleeding. INTERVENTION(S): Uterine artery embolization. MAIN OUTCOME MEASURE(S): Thirteen patients underwent UAE. Eleven patients had no additional vaginal bleeding, whereas two patients underwent hysterectomy after embolization. RESULT(S): Twelve patients developed AVMs after induced abortions. One patient had a congenital uterine AVM. Based on the transfer notes, eight cases had incomplete abortions, three cases had dysfunctional uterine bleeding, one case had a molar pregnancy, and one case had a uterine AVM. Two cases underwent hysterectomy after UAE. One patient delivered a healthy baby after bilateral UAE. CONCLUSION(S): Uterine AVMs should be suspected in patients with abrupt, profuse vaginal bleeding and a medical history of an induced abortion. Primary physicians should consider uterine AVMs with such a medical history. A prompt diagnosis and therapy are essential for favorable outcomes in patients with uterine AVMs.
