案例330:卵巢扭曲在卵巢过度刺激综合征的设置中
Maria Zulfiqar1, Fatima Al Khafaji1, Megan Wasson1
1From the Departments of Abdominal Imaging (M.Z.) and Gynecology (M.W.), Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054; and University of Arizona, Banner University Medical Center, Tucson, Ariz (F.A.K.).
Radiology
|October 29, 2024
概括
这个案例研究突出了一个经历骨盆疼痛后卵细胞检索的患者. 通过盆腔MRI进行进一步的调查对于诊断和管理计划至关重要.
科学领域:
- 生殖医学 生殖医学
- 妇科外科手术 妇科外科
- 盆腔疼痛管理 盆腔疼痛管理
背景情况:
- 一个30岁的女性有子宫内膜异位症和不孕症史,在卵细胞检索一个月后出现了恶化的骨盆疼痛,经期不良和失精症.
- 患者有11年前因子宫内膜瘤和深透性子宫内膜异位症的左卵巢囊切除术的病史.
- 卵细胞检索因卵巢过度刺激综合征和腹腔内出血而复杂,需要进入重症监护室 (ICU).
研究的目的:
- 在辅助生殖技术 (ART) 程序后评估患有持续的骨盆疼痛的患者.
- 在患有子宫内膜异位症史的患者潜在胚胎移植前评估骨盆状况.
- 为了调查卵细胞检索后骨盆疼痛和尿膀压力恶化的原因.
主要方法:
- 临床评估包括生命体征,体检和实验室测试 (血清β-hCG,尿液分析).
- 盆腔磁共振成像 (MRI) 被用于评估盆腔结构并确定疼痛的来源.
- 审查患者的妇科和ART病史,包括之前的手术干预和卵细胞检索并发症.
主要成果:
- 身体检查显示有轻微的骨盆疼痛;生命体征表明血压升高.
- 实验室测试在正常范围内,怀孕测试呈阴性.
- 骨盆MRI进行,以调查持续的骨盆疼痛和膀压力的原因.
结论:
- 这一案例强调了在接受ART的患者中对盆腔疼痛进行全面评估的重要性,特别是在有子宫内膜异位症史的患者中.
- 盆腔MRI是诊断有助于疼痛后卵细胞检索的妇科疾病的宝贵工具.
- 管理策略应解决与子宫内膜异位症相关的疼痛和ART程序的潜在并发症.
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