深度浸潤型子宮內膜異位症造成延遲性產後大出血之個案報告

Deep infiltrating endometriosis (DIE) related left uterine laceration causing severe post-partum hemorrhage: a case report and literature review

在懷孕過程中因子宮內膜異位症造成自發性腹內出血相對少見，但通常是危及生命 的嚴重併發症。在此介紹一個於真空吸引輔助陰道分娩後6 天發現嚴重腹內出血的 病例。此病例於剖腹探查時發現：子宮左後壁缺損伴隨左側子宮動脈活動性出血， 周圍組織碎裂且易於出血。在打開後腹膜並分離輸尿管以後，我們進行了左側子宮 動脈阻斷手術以減緩出血。術後病例切片顯示為子宮內膜異位組織且無蛻膜化蛻 變。

Complication of spontaneous hemoperitoneum related to endometriosis during pregnancy are rare but usually represent life-threatening conditions. We presented a case that suffered from massive hemoperitoneum 6 days after vacuum assisted vaginal delivery. Within exploratory laparotomy, left posterior uterine wall defect with left uterine artery active bleeding were noted. Surrounding tissue was fragile and easily touch-bleeding. After open the retroperitoneum and separated the ureter, we performed the left uterine artery ligation. Pathology of fragile tissue showed compatible with endometriosis without decidual change.