RESUMO
La inversión uterina no puerperal es un suceso muy infrecuente. La presencia de un mioma submucoso fúndico es, a menudo, la causa de esta extraña entidad pero el diagnóstico es difícil y requiere un alto índice de sospecha. Describimos el caso de una mujer de 53 años que presentaba sangrado, dolor abdominal y una gran masa protruyendo a través de vagina.Se practicó una histerectomía abdominal y se halló una inversión uterina completa (AU)
Non-puerperal uterine inversion is a very infrequent event. The cause is often the presence of a fundal submucous leiomyoma, but diagnosis is difficult and requires a high index of suspicion. We describe the case of a 53-year-old woman who presented with bleeding, abdominal pain and a large mass protruding through the vagina. An abdominal hysterectomy was performed, which revealed complete uterine inversion (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Inversão Uterina/diagnóstico , Inversão Uterina/cirurgia , Histerectomia Vaginal/instrumentação , Histerectomia Vaginal/métodos , Leiomioma/complicações , Leiomioma/diagnóstico , Leiomioma/cirurgia , Inversão Uterina/fisiopatologia , Inversão Uterina , Dor Abdominal/complicações , Dor Abdominal/etiologiaRESUMO
The uterine inversion is a rare gynecologic complication. Usually, it is extremely serious obstetric complication exposing the young mother at the risk of postpartum haemorrhage. We report the case of a 57-year-old woman, hemodynamically unstable at admission, with an acute uterine inversion a complete fundic submucosal myoma. The surgical management was done by a double approach: laparoscopic and vaginal. Although rare and difficult diagnosis, the acute non-puerperal uterine inversion is a medical-surgical emergency caused by an intracavitary expansive process.
Assuntos
Inversão Uterina/diagnóstico , Inversão Uterina/cirurgia , Feminino , Humanos , Histerectomia , Laparoscopia , Leiomioma/complicações , Leiomioma/diagnóstico , Leiomioma/cirurgia , Pessoa de Meia-Idade , Inversão Uterina/fisiopatologia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgiaRESUMO
La inversión uterina es una de las complicaciones más graves que pueden suceder en la tercera etapa del parto. Presentamos el caso de una gestación que finaliza en un parto eutócico, objetivando una inversión uterina total, que no se puede resolver por vía vaginal precisando abordaje laparotómico. La inversión se reduce mediante presión manual del cuerpo uterino hasta que el fondo uterino queda totalmente repuesto. La evolución posterior de la paciente es favorable. Hemos realizado una revisión de la literatura científica analizando la incidencia, factores de riesgo, clasificación, clínica y opciones terapéuticas relacionadas con dicha complicación (AU)
Uterine inversion is one of the most life-threatening obstetric emergencies that can occur during the third stage of labor. We present a case of acute complete uterine inversion following a vaginal birth. Manual vaginal manipulation was unsuccessful and surgical reduction by laparotomy was required. During the repositioning procedure, manual pressure was applied to the uterine body until the fundus reached its anatomic position. Subsequent patient outcome was favourable. A review of the literature was performed, focusing on the epidemiology, risk factors, classification, clinical findings and management of this complication (AU)
Assuntos
Humanos , Feminino , Gravidez , Adulto , Inversão Uterina/diagnóstico , Inversão Uterina/cirurgia , Laparotomia/métodos , Laparotomia , Medicina de Emergência/métodos , Fatores de Risco , Inversão Uterina/fisiopatologia , Inversão UterinaRESUMO
Acute puerperal uterine inversion is a rare but potentially fatal obstetric emergency in which the uterine fundus collapses into the uterine cavity. Maternal mortality is high unless the condition is recognised and quickly corrected. The duration of time elapsed from moment of diagnosis to that of correction, along with rapid resuscitation measures are of utmost importance in its prognosis. A recent case managed successfully is described followed by a short review of the literature.
Assuntos
Transtornos Puerperais/diagnóstico , Transtornos Puerperais/terapia , Inversão Uterina/diagnóstico , Inversão Uterina/terapia , Doença Aguda , Adulto , Cuidados Críticos , Diagnóstico Precoce , Feminino , Humanos , Hemorragia Pós-Parto/etiologia , Gravidez , Prognóstico , Transtornos Puerperais/fisiopatologia , Ressuscitação , Fatores de Tempo , Inversão Uterina/fisiopatologiaRESUMO
Se describe el caso de una gestante que en 2 ocasiones y de forma consecutiva presentó, poco antes del término, una actividad uterina descoordinada sin modificaciones cervicales y que fue diagnosticada de distocia dinámica por inversión del triple gradiente de contracción. Desde los años cincuenta se conoce su existencia, pero nunca se había podido explicar la causa de este fenómeno. A través de la revisión bibliográfica se analizan las posibles causas y los distintos tratamientos empleados en su resolución
We describe the case of a pregnant woman who, on two consecutive occasions and shortly before term, presented uncoordinated uterine activity without cervical modification and who was diagnosed with dynamic dystocia due to inversion of the triple contraction gradient. This phenomenon has been known since the 1950s but its cause has never been explained. We performed a literature review to analyze its possible causes and the various treatments used to resolve it
