■子宫结肠瘘是宫内节育器(IUD)插入的并发症之一。宫内节育器材料不仅可能导致穿孔,但其他一些危险因素可能有助于其发展,包括子宫异常,因此,IUD在有解剖异常的患者中是禁忌的。
■P3A1女人,50岁,有16年的宫内节育器使用史,8个月前出现阴道粪便排出的投诉,宫内节育器取出后恶化。体格检查无腹部压痛。窥器检查发现宫颈管中有粪便。CT扫描检查显示多个子宫结肠瘘和子宫双子宫。进行了诊断性腹腔镜和宫腔镜检查,发现了子宫瘘,然后安排患者用吻合器方法进行结肠造口和再吻合。
■尽管有适当的成像方式,诊断还是很难确定。使用直接视觉诊断(宫腔镜和腹腔镜检查)可以诊断子宫结肠瘘。据我们所知,这是首例长期使用宫内节育器和宫内节育器的患者发生直肠-子宫瘘的病例报告.
UNASSIGNED: Uterocolon fistula is one of the complications of intrauterine device (IUD) insertion. Not only may IUD materials cause perforation, but some other risk factors may contribute to its development including uterine abnormalities, thus IUD is contraindicated in patients with anatomical anomaly.
UNASSIGNED: P3A1 woman, 50 years old with a history of IUD use for 16 years presented with complaints of fecal discharge from the vagina 8 months ago which worsened after IUD extraction. Physical examination revealed no abdominal tenderness. Speculum examination found feces in the cervical canal. CT scan examination showed multiple uterocolon fistulas and uterine didelphys. Diagnostic laparoscopy and hysteroscopy were carried out and found a recto-uterine fistula, then the patient was scheduled for colostomy and reanastomosis with the stapler method.
UNASSIGNED: Diagnosis was very difficult to establish despite proper imaging modalities. The use of direct visual diagnostics (hysteroscopy and laparoscopy) can be a good alternative for the diagnosis of uterocolon fistula. To the best of our knowledge, this is the first case report on recto-uterine fistula in a patient with long-term use of IUD and uterine didelphys.