METHODS: A 44-year-old female was admitted due to progressive abdominal pain during menstruation for 30 years and no relief 1 year after MWA. Hysterectomy was performed. Intraoperative findings: pelvic inflammatory exudation; the uterus and the left adnexa were extensively and densely adhered to the intestine, bladder, pelvic wall and surrounding tissues; the local tissue of the uterus was brittle and dark yellow. Intestinal obstruction, abdominal infection and urinary fistula occurred after hysterectomy.
METHODS: 1. Adenomyosis. 2. Endometrial polyps. 3. Left chocolate cyst of ovary. 4. Pelvic adhesions. 5. Pelvic inflammation.
METHODS: The patient underwent intestinal obstruction catheter implantation, ultrasound-guided pelvic fluid mass puncture drainage, right kidney puncture and fistula drainage, right ureteral bladder replantation, and right ureteral stent implantation.
RESULTS: After 48 days of comprehensive treatment, the patient was cured and discharged.
CONCLUSIONS: Microwave ablation has a poor therapeutic effect on diffuse adenomyosis, and should avoid excessive ablation during the ablation process.
方法:一名44岁女性因月经期间进行性腹痛30年而入院,MWA后1年无缓解。进行子宫切除术。术中发现:盆腔炎性渗出,子宫及左侧附件广泛致密地粘附于肠道,膀胱,盆腔壁及周围组织;子宫局部组织脆性,呈深黄色。肠梗阻,子宫切除术后发生腹腔感染和尿瘘。
方法:1.子宫腺肌病。2.子宫内膜息肉。3.卵巢左侧巧克力囊肿。4.盆腔粘连。5.盆腔炎.
方法:患者行肠梗阻导管植入术,超声引导盆腔积液穿刺引流,右肾穿刺和瘘引流,右输尿管膀胱再植术,和右输尿管支架植入术。
结果:经过48天的综合治疗,病人痊愈出院。
结论:微波消融对弥漫性子宫腺肌病的治疗效果较差,并应避免在消融过程中过度消融。