2 English reference horn uterus
3 disease alias residual horn uterus
4 Classification of Obstetric and Gynecological Diseases
5 Overview of the disease Residual horn uterus, also known as residual horn uterus, is relatively rare, and the complications of residual horn uterus are even rarer and extremely difficult to diagnose. The author collected 9 cases of uterine complications of residual horn and reviewed the literature at home and abroad.
Case data: Nine patients with uterine complications of residual horn were hospitalized or out-patient (follow-up) in our hospital1991999, aged from 22 to 41year. Among 9 cases, 5 cases were left and 4 cases were right. There were 2 cases of type ⅰ, 6 cases of type ⅱ, and type ⅲ 1 case. Adenomyosis of remnant horn 1 case, hysteromyoma in 2 cases, live embryo in early pregnancy in 2 cases, hematocele in 2 cases, dead embryo in early pregnancy 1 case, and early pregnancy rupture 1 case. The clinical manifestations of non-pregnant patients with residual horn uterus are amenorrhea and severe dysmenorrhea; Patients with residual horn of pregnancy presented with abdominal pain and a small amount of bleeding. The final diagnosis of this disease is mainly based on clinical symptoms and signs, CT, MRI, B-ultrasound or hysterography and intraoperative findings. Hysterectomy and salpingectomy were performed in 8 cases, 1 Hysterectomy and appendectomy were performed.
Literature [1 ~ 12] reported 27 cases of cornual complications, including left 12 cases, right 14 cases and bilateral 1 case. There were 2 cases of type ⅰ (7.40%), 22 cases of type ⅱ (8 1.49%) and 3 cases of type ⅲ (11.1%). There were 5 cases of adenomyosis (18.5 1%), 6 cases of early pregnancy rupture (22.22%), intrauterine pregnancy 1 case (3.70%) and early pregnancy live embryo1case (37.71case). Among the 27 cases, 9 cases were hysterectomy plus round ligament fixation, 7 cases were hysterectomy plus salpingectomy, 6 cases were hysterectomy and its appendages, 65,438+0 cases were normal uterus, 65,438+0 cases were hysterectomy and its bilateral appendages, 6 cases were cesarean section and resection, and 3 cases were hysterectomy, salpingectomy and myoma.
6 Description of the disease One side of the accessory mesonephros develops normally, and the other side is underdeveloped to form a remnant horn uterus, which may be accompanied by abnormal urinary tract development. Most of the uterus with residual horn is not connected with the contralateral normal uterine cavity, but only connected with fibrous band; Occasionally there are narrow pipe connections.
7 Symptoms and signs If the residual horn endometrium has no function, it is generally asymptomatic; If the endometrium is functional and does not communicate with the normal uterine cavity, dysmenorrhea will often occur due to hematocele in the uterine cavity, and even endometriosis will occur. If the pregnancy occurs in the uterus with residual horn, it should not be scraped during induced abortion. From 0/6 to 20 weeks of pregnancy, the rupture surface often has typical symptoms of tubal pregnancy rupture, with a large amount of bleeding. If the ruptured uterus with residual horn is not surgically removed in time, the patient may die of massive internal bleeding.
The etiology of the disease is that one side of the accessory mesonephric duct develops normally and the other side is hypoplastic.
It is easy to misdiagnose the residual horn uterus as ovarian tumor in diagnosis and examination. Laparoscopic diagnosis can be performed.
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