Abstract:
Gynecological emergencies can often present with a myriad of non-specific signs and symptoms, posing a diagnostic challenge to the clinician. They can be grossly divided into uterine or adnexal pathologies. Uterine pathologies can be secondary to intracavitary accumulation of blood [like in patients with transverse vaginal septum, Robert\'s uterus, accessory and cavitated uterine mass, unicornuate uterus with contralateral non-communicating functional horn], bleeding per vaginum [like in patients with retained products of conception, enhanced myometrial vascularity], pyometra [secondary to pelvic inflammatory disease, cervical obstruction secondary to benign and malignant causes] or complications of fibroids [like red degeneration, torsion of subserosal fibroid]. The adnexal pathologies can range from ectopic pregnancy in a urine pregnancy test (UPT) positive patient to haemorrhagic ovarian cyst, ovarian torsion, ruptured dermoid cyst and tubo-ovarian abscess in a UPT negative patient. Multimodality imaging including ultrasound (USG), computed tomography (CT) scan and magnetic resonance imaging (MRI) can narrow down the differentials and help in formulating an accurate diagnosis. The objective of this article is to familiarize the readers with multimodality imaging findings in common as well as uncommon acute gynecological emergencies and provide an algorithmic imaging approach for acute gynecological emergencies. USG is typically used as the first line diagnostic modality in diagnosis of acute gynecological emergencies. CT scan & MRI are helpful as a problem-solving tool in acute gynecological emergencies when USG findings are indeterminate.
摘要:
妇科紧急情况通常会出现无数的非特异性体征和症状,对临床医生构成诊断挑战。它们可以大致分为子宫或附件病理。子宫病变可继发于腔内积聚的血液[如阴道横隔患者,罗伯特的子宫,附件和空化的子宫肿块,带有对侧非交通功能角的单角子宫],每次阴道出血[像保留有受孕产物的患者一样,增强的子宫肌层血管分布],宫腔炎[继发于盆腔炎,继发于良性和恶性原因的宫颈梗阻]或肌瘤并发症[如红色变性,浆膜下肌瘤扭转]。附件病理范围从尿妊娠试验(UPT)阳性患者的异位妊娠到出血性卵巢囊肿,卵巢扭转,UPT阴性患者皮样囊肿破裂和输卵管卵巢脓肿。包括超声(USG)在内的多模态成像,计算机断层扫描(CT)扫描和磁共振成像(MRI)可以缩小差异,并有助于制定准确的诊断。本文的目的是使读者熟悉常见和罕见的急性妇科紧急情况的多模态成像发现,并为急性妇科紧急情况提供算法成像方法。USG通常用作诊断急性妇科紧急情况的一线诊断方式。当USG发现不确定时,CT扫描和MRI可作为急性妇科紧急情况的解决问题的工具。