巨大的阴道出血的不寻常原因
Justin Wen Hao Leong1, Liying Yang2, Kevin Kim Jun Teh1
1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.
ACG case reports journal
|September 8, 2025
概括
肝硬化患者的大量阴道出血可以表明罕见的外宫盆腔静脉,特别是子宫静脉. 血管栓塞成功治疗了一例由宫变形引起的巨大的阴道出血病例.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 血管外科 血管外科
- 干预性放射学 干预性放射学
背景情况:
- 肝硬化通常会导致门高血压和移植系统性静脉动脉的发展.
- 宫外静脉出血,特别是从盆腔静脉出血,是一种罕见的,但在肝硬化患者中可能危及生命的并发症.
- 巨大的阴道出血是异常表现的宫外静脉.
研究的目的:
- 报告一个罕见的严重的阴道通道出血的病例,由肝硬化患者的子宫变节引起.
- 强调在肝硬化患者出现不明原因的大量阴道出血时考虑异宫静脉的重要性.
- 讨论通过干预性放射学成功管理这种罕见的并发症.
主要方法:
- 一名60岁的绝经后妇女患有已知的肝硬化,出现大量的阴道出血.
- 诊断工作包括计算机断层扫描 (CT) 扫描,揭示了广泛的移植系统附带物和子宫.
- 患者经历了子宫和骨静脉分流的成功血管学栓塞.
主要成果:
- CT扫描发现从脏静脉到之前的剖腹产痕区域的大型附带血管,起源于子宫.
- 血管造血栓塞有效地消除了子宫静脉和脏静脉,控制了大量的出血.
- 患者的病情在干预程序后得到稳定.
结论:
- 在肝硬化患者中,大量的阴道出血需要高的怀疑指数,以异位性静脉出血为准,特别是子宫静脉.
- 及时咨询第三级肝脏单位对于诊断和管理至关重要.
- 干预性放射性程序,如血管造血栓塞,为控制来自子宫静脉和移植系统分流的出血提供了成功的治疗选择,降低了复发风险.
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