PDF(Pubmed)
Abstract：
Rupture of a gravid uterus is a known complication of a cesarean hysterotomy. Uterine rupture of a nongravid uterus is usually caused by trauma, instrumentation, a pelvic mass, infection, or malignancy. Spontaneous rupture of a nongravid uterus is a rare event with only 4 cases reported in the English literature since 2011. This was the case of a healthy 52-year-old woman with a remote history of 2 cesarean deliveries and an endometrial ablation. The patient presented with severe right lower-quadrant pain. The hospital evaluation revealed a hemoperitoneum, a 5 cm endometrial complex or mass, and layering of blood product along the cesarean delivery scar. Exploration confirmed a spontaneous rupture of the previous hysterotomy. The patient was treated successfully with a total abdominal hysterectomy. Pathology report confirmed the uterine wall defect. Uterine rupture in the non-gravid uterus is a rare event. Presentation may be atypical but consistent with the diagnosis. Spontaneous uterine rupture should be considered in the nongravid patient with abdominal pain and a hemoperitoneum of unclear origin.
摘要：
妊娠子宫破裂是剖宫产子宫切开术的已知并发症。子宫破裂通常是由外伤引起的，仪器仪表,骨盆肿块,感染,或者恶性肿瘤。非子宫自发性破裂是罕见事件，自2011年以来，英文文献中仅报道了4例。这是一名健康的52岁女性，有2次剖宫产和子宫内膜消融术的遥远病史。患者出现严重的右下腹疼痛。医院评估显示腹膜积血,5厘米的子宫内膜复合体或肿块，和沿着剖宫产瘢痕分层的血液制品。探查证实先前的子宫切开术自发破裂。患者经腹式全子宫切除术成功治疗。病理报告证实子宫壁缺损。非妊娠子宫破裂是罕见事件。表现可能不典型，但与诊断一致。对于腹痛和不明原因的腹膜积血的患者，应考虑自发性子宫破裂。
