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患者,59岁,住院号291388。于1986年10月28日以白带增多一年,阴道流脓25天入院,该患宫腔内置放金属节育环已20年,绝经13年来无何异常。1985年10月无任何诱因阴道流血少量,持续3～4天,无腹痛、发热及性交出血。从此以后阴道流水样白带,量多无味。1986年8月在当地医院取环,未成功。而后发热一周,阴道流脓性白带多量,伴腹痛。当地医院经阴道由宫腔抽脓、冲洗,静滴抗生素,好转后来我院就诊。宫颈刮片及分段刮宫送病理检查,报告为宫颈管慢性炎症,子宫内膜非典型增生。B 超所见:宫腔内可见6.3×4.3cm 液性暗区,后方回声增强。入院诊断疑子宫内膜癌合并宫腔积脓。于1986年11月6日行开腹手术,术中见子宫稍小,表面光滑,颜色正常,双侧卵巢萎缩,其它未见异常。行子宫全切及双侧附件切除术,术后切口Ⅰ期愈合,术后14天出院。剖开子宫标本,可见宫腔内有一将节育环包裹的纤维化块约3×2.5cm,坚硬如石,游离于宫腔内,子宫内膜不厚。病理诊断:宫腔内节育环纤维素包裹、钙化。
Patient, 59 years old, hospital number 291388. On October 28, 1986 leucorrhea increased by one year, vaginal pus 25 days admitted, the intrauterine implantation of metal IUDs have been 20 years, 13 years without any abnormal menopause. October 1985 without any incentive vaginal bleeding a small amount of sustained 3 to 4 days, no abdominal pain, fever and sexual bleeding. Since then vaginal fluid leucorrhea, the amount of more tasteless. In August 1986 in the local hospital ring, unsuccessful. Then fever a week, vaginal purulent vaginal discharge amount, with abdominal pain. Transvaginal local hospitals by the uterine pus, irrigation, intravenous antibiotics, improved later our hospital. Cervical smears and sub-curettage to send pathology, reported chronic inflammation of the cervical canal, endometrial dysplasia. B seen: intrauterine visible 6.3 × 4.3cm liquid dark area, the rear echo enhancement. Admission diagnosis of suspected endometrial cancer with uterine empyema. On November 6, 1986 underwent open surgery, see the uterus surgery is slightly smaller, the surface is smooth, normal color, both ovaries atrophy, the other without exception. Hysterectomy and bilateral attachment resection, incision healed after surgery, 14 days after discharge. Cut open the uterus specimens, we can see a intrauterine fibrosis block wrapped around the IUD is about 3 × 2.5cm, hard as stone, free from the uterine cavity, the endometrium is not thick. Pathological diagnosis: IUD intrauterine loop wrapped with cellulose, calcification.