OBJECTIVE:To report a case of cystic cervical endometriosis that caused a massive hemorrhage due to rupture of a cyst and successful management with a loop electrosurgical excision procedure (LEEP). DESIGN:Case report. SETTING:University Hospital. PATIENT:A 37-year-old nulliparous woman. INTERVENTION(S):Medical management including surgical treatment. MAIN OUTCOME MEASURE(S):Clinical follow-up and pathologic diagnosis. RESULT(S):A hemorrhagic cystic cervical mass was excised with emergent LEEP. The mass was found to be cervical endometriosis. There was no evidence of recurrence until 1 year after excision. CONCLUSION(S):Cystic formation of cervical endometriosis--like ovarian endometrioma, which causes a massive hemorrhage due to rupture--is extremely rare, although cervical endometriosis is generally asymptomatic. Hysterectomy is considered in such cases but can be avoided via LEEP that incorporates partial excision of the uterine cervix.

译文

目的:报道一例因囊肿破裂而导致大出血的囊性宫颈子宫内膜异位症患者,并采用环行电外科切除术(LEEP)成功治疗。
设计:病例报告。
单位:大学医院。
患者:一位37岁的未产妇。
干预措施:医疗管理,包括外科治疗。
主要观察指标:临床随访和病理诊断。
结果:出血的囊性宫颈肿块被紧急LEEP切除。发现该肿块是宫颈子宫内膜异位症。直到切除后1年,才有复发的迹象。
结论:尽管通常子宫内膜异位症无症状,但很少发生膀胱内膜异位症的囊性形成(如卵巢内膜瘤,由于破裂而引起大量出血)。在这种情况下,可以考虑行子宫切除术,但可以通过合并子宫部分切除的LEEP手术来避免。

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