Hypertrophy of the uterus is due to consecutive multiple pregnancy, childbirth, chronic inflammation or uterus, uterine wall fiber proliferation of connective tissue disease. Because of its low incidence of clinical performance similar to uterine fibroids, adenomyosis and dysfunctional uterine bleeding (blood work), easily misdiagnosed. Our hospital in January 1980 to October 1997 were treated 41 cases of uterine mast, are misdiagnosed, the analysis of the report are as follows.
1 clinical data
1.1 general information on the incidence of this age group 28 to 54 years old, an average of 46.2 years of age. Marriage age <20 38 cases, full-term birth four times more than 37 cases.
1.2 clinical manifestations of 38 cases a period of increased menstrual extended, four cases of the menstrual cycle shortened, three cases have lower abdominal pain or discomfort history.
1.3-assisted check B-41 routine inspection, are indications that the uterus increases, including 26 cases of uterine fibroids, seven cases of adenomyosis. 10 cases before operation of diagnostic curettage, a pathology report for the seven cases of endometrial hyperplasia have Shing.
1.4 misdiagnosed disease and surgery for uterine fibroids misdiagnosis seen 29 cases, seven cases of adenomyosis, Gong blood five cases. 41 cases were performed Caesarean section hysterectomy. See in the uterus of uniform size increase, smooth surface. Pathological examination reports: 41 cases are hypertrophy of the uterus, uterine fibroids and with no adenomyosis.
2 discussion
① 2.1 misdiagnosis of the disease rare. Our hospital in January 1980 to October 1997 to hysterectomy patients in the 660 cases, the mast of the uterus only 41 cases, accounting for 6.2 percent. ② related literature has not yet aroused the attention of physicians, specialist physicians lack the knowledge of the uterus mast, considering the time of diagnosis and more common diseases, leading to misdiagnosis. ③ on condition of not comprehensive, single and thinking, the number of menstruation, menstrual extension of the uterus on the increase of cases diagnosed with uterine fibroids. 41 cases of this group attending the first impression for almost all of uterine fibroids, the neglect of hypertrophy of the uterus, resulting in before, during repeatedly misdiagnosed. ④ mast of the uterus without a clear diagnostic criteria.
2.2 The author made the following diseases and the need to identify
2.2.1 uterine fibroids: ① uterine fibroids patients often without prolific history, but some patients have combined the history of infertility or miscarriage. Gynaecological examinations at the Palace of uterine fibroids for not more than symmetry processes, quality hardware, the Palace of size depends on the size and number of how many fibroids, submucosal fibroids in more than blowing up when touched, and uterine hypertrophy of the uterus by a uniform , For more than two months of pregnancy size, a small number of three-month pregnancy size, soft. ② uterine fibroids especially the larger fibroids, oppression symptoms are often more pronounced, Mast of the uterus and the general oppression no symptoms.
2.2.2 adenomyosis: ① adenomyosis many infertility, dysmenorrhea, in particular, aggravated sexual history of dysmenorrhea. ② gynaecological examination of adenomyosis showed increased uterine uniform texture but hard. ③ uterine lipiodol contrast to the diagnosis of the disease to a certain extent help. This shows that intrauterine expanded access to iodized oil from the uterine muscle, a kind diverticulum processes.
2.2.3 Gong blood: ① more reactive blood after menarche in or near menopause, menopause performance in the short-term amenorrhea follow-up to massive bleeding, uterine mast in general do not occur in adolescent women, menstrual bleeding for more performance and more normal cycle Or shortened. ② gynaecological examinations of patients uterine blood work normal size or slightly increased, and uterine hypertrophy of the general increase significantly. Such as the Bank of blowing up the 10 cases, seven cases of endometrial hyperplasia pathology report of the Shing.
2.3 How objective analysis, evaluation of results of examinations had reported [1] B super-diameter <3 cm of uterine fibroids, the misdiagnosis rate was as high as 48.5 percent. And the Group of 41 cases of mast in the B-26 cases of uterine fibroids tips, in fact, fibroids diameter <3 cm, of which 22 cases of muscle intramural fibroids, one case of multiple fibroids. This may ① with the mast of uterine smooth muscle cells in the uterus mast, in muscle connective tissue proliferation, lymphatic and blood vessels clear expansion, proliferation, enhance the cause of the uterine wall echo. ② may ultrasonic transmission process in the body as a result of refraction, reflection and multiple scattering caused by a false impression, and so on. Therefore, clinical physician for the B-tips of small uterine fibroids in particular, no significant changes in the form of muscle intramural fibroids, in combination with history, symptoms, gynaecological examinations, to make the correct diagnosis and treatment.
2.4 Traiman [2] After the 43 cases diagnosed as hypertrophy of the uterus to hysterectomy and to carry out retrospective analysis, by its diagnosis should include bleeding, uterine symmetry increased, diffuse uterine muscle hypertrophy and exclude other endometrial Bleeding lesions. And in particular to help shape of indicators can be sure of their diagnosis, diagnostic criteria for the morphology of uterine weight ≥ 120 g, muscle thickness ≥ 2.0 cm. This should be the standard clinical diagnosis from doctors to the mast of the uterus to make a correct diagnosis.
1 clinical data
1.1 general information on the incidence of this age group 28 to 54 years old, an average of 46.2 years of age. Marriage age <20 38 cases, full-term birth four times more than 37 cases.
1.2 clinical manifestations of 38 cases a period of increased menstrual extended, four cases of the menstrual cycle shortened, three cases have lower abdominal pain or discomfort history.
1.3-assisted check B-41 routine inspection, are indications that the uterus increases, including 26 cases of uterine fibroids, seven cases of adenomyosis. 10 cases before operation of diagnostic curettage, a pathology report for the seven cases of endometrial hyperplasia have Shing.
1.4 misdiagnosed disease and surgery for uterine fibroids misdiagnosis seen 29 cases, seven cases of adenomyosis, Gong blood five cases. 41 cases were performed Caesarean section hysterectomy. See in the uterus of uniform size increase, smooth surface. Pathological examination reports: 41 cases are hypertrophy of the uterus, uterine fibroids and with no adenomyosis.
2 discussion
① 2.1 misdiagnosis of the disease rare. Our hospital in January 1980 to October 1997 to hysterectomy patients in the 660 cases, the mast of the uterus only 41 cases, accounting for 6.2 percent. ② related literature has not yet aroused the attention of physicians, specialist physicians lack the knowledge of the uterus mast, considering the time of diagnosis and more common diseases, leading to misdiagnosis. ③ on condition of not comprehensive, single and thinking, the number of menstruation, menstrual extension of the uterus on the increase of cases diagnosed with uterine fibroids. 41 cases of this group attending the first impression for almost all of uterine fibroids, the neglect of hypertrophy of the uterus, resulting in before, during repeatedly misdiagnosed. ④ mast of the uterus without a clear diagnostic criteria.
2.2 The author made the following diseases and the need to identify
2.2.1 uterine fibroids: ① uterine fibroids patients often without prolific history, but some patients have combined the history of infertility or miscarriage. Gynaecological examinations at the Palace of uterine fibroids for not more than symmetry processes, quality hardware, the Palace of size depends on the size and number of how many fibroids, submucosal fibroids in more than blowing up when touched, and uterine hypertrophy of the uterus by a uniform , For more than two months of pregnancy size, a small number of three-month pregnancy size, soft. ② uterine fibroids especially the larger fibroids, oppression symptoms are often more pronounced, Mast of the uterus and the general oppression no symptoms.
2.2.2 adenomyosis: ① adenomyosis many infertility, dysmenorrhea, in particular, aggravated sexual history of dysmenorrhea. ② gynaecological examination of adenomyosis showed increased uterine uniform texture but hard. ③ uterine lipiodol contrast to the diagnosis of the disease to a certain extent help. This shows that intrauterine expanded access to iodized oil from the uterine muscle, a kind diverticulum processes.
2.2.3 Gong blood: ① more reactive blood after menarche in or near menopause, menopause performance in the short-term amenorrhea follow-up to massive bleeding, uterine mast in general do not occur in adolescent women, menstrual bleeding for more performance and more normal cycle Or shortened. ② gynaecological examinations of patients uterine blood work normal size or slightly increased, and uterine hypertrophy of the general increase significantly. Such as the Bank of blowing up the 10 cases, seven cases of endometrial hyperplasia pathology report of the Shing.
2.3 How objective analysis, evaluation of results of examinations had reported [1] B super-diameter <3 cm of uterine fibroids, the misdiagnosis rate was as high as 48.5 percent. And the Group of 41 cases of mast in the B-26 cases of uterine fibroids tips, in fact, fibroids diameter <3 cm, of which 22 cases of muscle intramural fibroids, one case of multiple fibroids. This may ① with the mast of uterine smooth muscle cells in the uterus mast, in muscle connective tissue proliferation, lymphatic and blood vessels clear expansion, proliferation, enhance the cause of the uterine wall echo. ② may ultrasonic transmission process in the body as a result of refraction, reflection and multiple scattering caused by a false impression, and so on. Therefore, clinical physician for the B-tips of small uterine fibroids in particular, no significant changes in the form of muscle intramural fibroids, in combination with history, symptoms, gynaecological examinations, to make the correct diagnosis and treatment.
2.4 Traiman [2] After the 43 cases diagnosed as hypertrophy of the uterus to hysterectomy and to carry out retrospective analysis, by its diagnosis should include bleeding, uterine symmetry increased, diffuse uterine muscle hypertrophy and exclude other endometrial Bleeding lesions. And in particular to help shape of indicators can be sure of their diagnosis, diagnostic criteria for the morphology of uterine weight ≥ 120 g, muscle thickness ≥ 2.0 cm. This should be the standard clinical diagnosis from doctors to the mast of the uterus to make a correct diagnosis.
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