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Опыт лечения пиомиомы матки
Опыт лечения пиомиомы матки
Габидуллина Р.И., Мингазетдинов М.А., Дружкова Е.Б., Сирматова Л.И. Опыт лечения пиомиомы матки. Гинекология. 2020; 22 (5): 81–83.
DOI: 10.26442/20795696.2020.5.200399
DOI: 10.26442/20795696.2020.5.200399
DOI: 10.26442/20795696.2020.5.200399
________________________________________________
DOI: 10.26442/20795696.2020.5.200399
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Пиомиома матки – редкое и опасное осложнение миомы матки, развивающееся вследствие инфаркта миоматозного узла с присоединением инфекционного компонента. В литературе с 1945 г. описано 50 случаев пиомиомы, половина из которых связана с беременностью. Неправильная диагностика, отсутствие антибактериального и, в основном, хирургического лечения могут привести к летальному исходу. В статье представлен клинический случай развития пиомиомы матки после первых родов путем кесарева сечения. Применение метода эмболизации маточных артерий на фоне антибактериальной терапии позволило сохранить матку у молодой женщины. При последующем наблюдении менструальная функция полностью восстановилась.
Ключевые слова: пиомиома, эмболизация маточных артерий, послеродовый период.
Key words: pyomyoma, uterine artery embolization, postpartum period.
Ключевые слова: пиомиома, эмболизация маточных артерий, послеродовый период.
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Key words: pyomyoma, uterine artery embolization, postpartum period.
Полный текст
Список литературы
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[Dyachenko D.T., Stepovaya A.M., Dobryagina S.A. To the question about etiopathogenesis of the uterine leyomi and new approaches to the treatment. Journal Bulletin of the Russian Military Medical Academy. 2019; 1 (S1): 142–5 (in Russian).]
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[Tsareva S.N., Leshkovich A.S., Varigo N.V. Influence of pre-preparatory preparation on the course of pregnancy and delivery in women with myoma uterus. Medical Journal. 2020; 2: 115–7 (in Russian).]
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[Fominova G.V., Lyalichkina N.A., Kosenko Y.Y. et al. During the gestational process and delivery in patients with uterine myoma. Modern problems of science and education. 2018; 4: 138 (in Russian).]
6. Sheiner E, Bashiri A, Levy A et al. Obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas. J Reprod Med 2004; 49: 182e6.
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8. Ono H, Kanematsu M, Kato H et al. MR imaging findings of uterine pyomyoma: radiologic-pathologic correlation. Abdominal Imaging 2014; 39 (4): 797–801.
9. Bagga R, Rai R, Kalra J et al. An Unusual Cause of Postabortal Fever Requiring Prompt Surgical Intervention: A Pyomyoma and its Imaging Features. Oman Med J 2017; 32 (1): 73–6. DOI: 10.5001/omj.2017.14
10. Greenspoon JS, Ault M, James BA et al. Pyomyoma associated with polymicrobial bacteremia and fatal septic shock: Case report and review of the literature. Obstet Gynecol Sur 1990; 45 (9): 563–69.
11. Iwahashi N, Mabuchi Y, Shiro M et al. Large uterine pyomyoma in a perimenopausal female: A case report and review of 50 reported cases in the literature. Molecular and Clinical Oncology 2016; 5 (5): 527–31. DOI: 10.3892/mco.2016.1005
12. Karcaaltincaba M, Sudakoff GS. CT of a ruptured pyomyoma. Am J Roentgenol 2003; 181 (5): 1375–77. DOI: 10.2214/ajr.181.5.1811375
13. Abulafia O, Shah T, Salame G et al. Sonographic features associated with post-uterine artery embolization pyomyoma. J Ultrasound Med 2010; 29 (5): 839–42. DOI: 10.7863/jum.2010.29.5.839
14. Chen ZHY, Tsai HD, Sun MJ. Pyomyoma: a rare and life-threatening complication of uterine leiomyoma. Taiwan J Obstet Gynecol 2010; 49 (3): 351–6.
15. Yeat S-K, Chong K-M, Pan H-S et al. Impending sepsis due to a ruptured pyomyoma with purulent peritonitis: a case report and literature review. Taiwan J Obstet Gynecol 2005; 44 (1): 75–9.
16. DeMaio A, Doyle M. Pyomyoma as a Rare Source of Postpartum Sepsis. Case Rep Obstet Gynecol 2015; 2015: 263518. DOI: 10.1155/2015/263518
17. Kaler M, Gailer R, Iskaros J et al. Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon. Case Rep Obstet Gynecol 2015; 2015: 609205. DOI: 10.1155/2015/609205
18. Shiota M, Kotani Y, Ami K et al. Uterus-sparing myomectomy for uterine pyomyoma following cesarean section. Taiwan J Obstet Gynecol 2013; 52 (1): 140–1.
19. Sirha R, Miskin A, Abdelmagied A. Postnatal pyomyoma: a diagnostic dilemma. BMJ Case Rep 2013; 2013: bcr2013201137. DOI: 10.1136/bcr-2013-201137
20. Yu Q, Gabriel G, Hoffman M et al. Uterine-sparing management of pyomyoma after uterine fibroid embolization. Radiol Case Rep 2019; 14 (8): 1031–5. DOI: 10.1016/j.radcr.2019.05.009
2. Dyachenko D.T., Stepovaya A.M., Dobryagina S.A. To the question about etiopathogenesis of the uterine leyomi and new approaches to the treatment. Journal Bulletin of the Russian Military Medical Academy. 2019; 1 (S1): 142–5 (in Russian).
3. Lyutina K.V., Tyulkin R.V., Milchakov D.E. Gender changes in morbidity rate of benign hormone-dependent tumors in the first half of the 21st century. International research journal. 2017; 4–3: 166–9 (in Russian).
4. Tsareva S.N., Leshkovich A.S., Varigo N.V. Influence of pre-preparatory preparation on the course of pregnancy and delivery in women with myoma uterus. Medical Journal. 2020; 2: 115–7 (in Russian).
5. Fominova G.V., Lyalichkina N.A., Kosenko Y.Y. et al. During the gestational process and delivery in patients with uterine myoma. Modern problems of science and education. 2018; 4: 138 (in Russian).
6. Sheiner E, Bashiri A, Levy A et al. Obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas. J Reprod Med 2004; 49: 182e6.
7. Read S, Mullins J. Spontaneous Ruptured Pyomyoma in a Nulligravid Female: A Case Report and Review of the Literature. Case Rep Obstet Gynecol 2018; 2: 1026287. DOI: 10.1155/2018/1026287
8. Ono H, Kanematsu M, Kato H et al. MR imaging findings of uterine pyomyoma: radiologic-pathologic correlation. Abdominal Imaging 2014; 39 (4): 797–801.
9. Bagga R, Rai R, Kalra J et al. An Unusual Cause of Postabortal Fever Requiring Prompt Surgical Intervention: A Pyomyoma and its Imaging Features. Oman Med J 2017; 32 (1): 73–6. DOI: 10.5001/omj.2017.14
10. Greenspoon JS, Ault M, James BA et al. Pyomyoma associated with polymicrobial bacteremia and fatal septic shock: Case report and review of the literature. Obstet Gynecol Sur 1990; 45 (9): 563–69.
11. Iwahashi N, Mabuchi Y, Shiro M et al. Large uterine pyomyoma in a perimenopausal female: A case report and review of 50 reported cases in the literature. Molecular and Clinical Oncology 2016; 5 (5): 527–31. DOI: 10.3892/mco.2016.1005
12. Karcaaltincaba M, Sudakoff GS. CT of a ruptured pyomyoma. Am J Roentgenol 2003; 181 (5): 1375–77. DOI: 10.2214/ajr.181.5.1811375
13. Abulafia O, Shah T, Salame G et al. Sonographic features associated with post-uterine artery embolization pyomyoma. J Ultrasound Med 2010; 29 (5): 839–42. DOI: 10.7863/jum.2010.29.5.839
14. Chen ZHY, Tsai HD, Sun MJ. Pyomyoma: a rare and life-threatening complication of uterine leiomyoma. Taiwan J Obstet Gynecol 2010; 49 (3): 351–6.
15. Yeat S-K, Chong K-M, Pan H-S et al. Impending sepsis due to a ruptured pyomyoma with purulent peritonitis: a case report and literature review. Taiwan J Obstet Gynecol 2005; 44 (1): 75–9.
16. DeMaio A, Doyle M. Pyomyoma as a Rare Source of Postpartum Sepsis. Case Rep Obstet Gynecol 2015; 2015: 263518. DOI: 10.1155/2015/263518
17. Kaler M, Gailer R, Iskaros J et al. Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon. Case Rep Obstet Gynecol 2015; 2015: 609205. DOI: 10.1155/2015/609205
18. Shiota M, Kotani Y, Ami K et al. Uterus-sparing myomectomy for uterine pyomyoma following cesarean section. Taiwan J Obstet Gynecol 2013; 52 (1): 140–1.
19. Sirha R, Miskin A, Abdelmagied A. Postnatal pyomyoma: a diagnostic dilemma. BMJ Case Rep 2013; 2013: bcr2013201137. DOI: 10.1136/bcr-2013-201137
20. Yu Q, Gabriel G, Hoffman M et al. Uterine-sparing management of pyomyoma after uterine fibroid embolization. Radiol Case Rep 2019; 14 (8): 1031–5. DOI: 10.1016/j.radcr.2019.05.009
2. Дьяченко Д.Т., Степовая А.М., Добрягина С.А. К вопросу об этиопатогенезе лейомиом матки и новых подходов к лечению. Известия Российской Военно-медицинской академии. 2019; 1 (S1): 142–5.
[Dyachenko D.T., Stepovaya A.M., Dobryagina S.A. To the question about etiopathogenesis of the uterine leyomi and new approaches to the treatment. Journal Bulletin of the Russian Military Medical Academy. 2019; 1 (S1): 142–5 (in Russian).]
3. Лютина К.В., Тюлькин Р.В., Мильчаков Д.Е. Гендерные изменения в структуре заболеваемости доброкачественными гормонзависимыми опухолями в первой половине XXI века. Междунар. научно-исследовательский журн. 2017; 4–3: 166–9.
[Lyutina K.V., Tyulkin R.V., Milchakov D.E. Gender changes in morbidity rate of benign hormone-dependent tumors in the first half of the 21st century. International research journal. 2017; 4–3: 166–9 (in Russian).]
4. Царева С.Н., Лешкович А.С., Вариго Н.В. Влияние прегравидарной подготовки на течение беременности и родов у женщин с миомой матки. Мед. журн. 2020; 2: 115–7.
[Tsareva S.N., Leshkovich A.S., Varigo N.V. Influence of pre-preparatory preparation on the course of pregnancy and delivery in women with myoma uterus. Medical Journal. 2020; 2: 115–7 (in Russian).]
5. Фоминова Г.В., Ляличкина Н.А., Косенко Ю.Ю. и др. Течение гестационного процесса и родоразрешение пациенток с миомой матки. Совр. проблемы науки и образования. 2018; 4: 138.
[Fominova G.V., Lyalichkina N.A., Kosenko Y.Y. et al. During the gestational process and delivery in patients with uterine myoma. Modern problems of science and education. 2018; 4: 138 (in Russian).]
6. Sheiner E, Bashiri A, Levy A et al. Obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas. J Reprod Med 2004; 49: 182e6.
7. Read S, Mullins J. Spontaneous Ruptured Pyomyoma in a Nulligravid Female: A Case Report and Review of the Literature. Case Rep Obstet Gynecol 2018; 2: 1026287. DOI: 10.1155/2018/1026287
8. Ono H, Kanematsu M, Kato H et al. MR imaging findings of uterine pyomyoma: radiologic-pathologic correlation. Abdominal Imaging 2014; 39 (4): 797–801.
9. Bagga R, Rai R, Kalra J et al. An Unusual Cause of Postabortal Fever Requiring Prompt Surgical Intervention: A Pyomyoma and its Imaging Features. Oman Med J 2017; 32 (1): 73–6. DOI: 10.5001/omj.2017.14
10. Greenspoon JS, Ault M, James BA et al. Pyomyoma associated with polymicrobial bacteremia and fatal septic shock: Case report and review of the literature. Obstet Gynecol Sur 1990; 45 (9): 563–69.
11. Iwahashi N, Mabuchi Y, Shiro M et al. Large uterine pyomyoma in a perimenopausal female: A case report and review of 50 reported cases in the literature. Molecular and Clinical Oncology 2016; 5 (5): 527–31. DOI: 10.3892/mco.2016.1005
12. Karcaaltincaba M, Sudakoff GS. CT of a ruptured pyomyoma. Am J Roentgenol 2003; 181 (5): 1375–77. DOI: 10.2214/ajr.181.5.1811375
13. Abulafia O, Shah T, Salame G et al. Sonographic features associated with post-uterine artery embolization pyomyoma. J Ultrasound Med 2010; 29 (5): 839–42. DOI: 10.7863/jum.2010.29.5.839
14. Chen ZHY, Tsai HD, Sun MJ. Pyomyoma: a rare and life-threatening complication of uterine leiomyoma. Taiwan J Obstet Gynecol 2010; 49 (3): 351–6.
15. Yeat S-K, Chong K-M, Pan H-S et al. Impending sepsis due to a ruptured pyomyoma with purulent peritonitis: a case report and literature review. Taiwan J Obstet Gynecol 2005; 44 (1): 75–9.
16. DeMaio A, Doyle M. Pyomyoma as a Rare Source of Postpartum Sepsis. Case Rep Obstet Gynecol 2015; 2015: 263518. DOI: 10.1155/2015/263518
17. Kaler M, Gailer R, Iskaros J et al. Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon. Case Rep Obstet Gynecol 2015; 2015: 609205. DOI: 10.1155/2015/609205
18. Shiota M, Kotani Y, Ami K et al. Uterus-sparing myomectomy for uterine pyomyoma following cesarean section. Taiwan J Obstet Gynecol 2013; 52 (1): 140–1.
19. Sirha R, Miskin A, Abdelmagied A. Postnatal pyomyoma: a diagnostic dilemma. BMJ Case Rep 2013; 2013: bcr2013201137. DOI: 10.1136/bcr-2013-201137
20. Yu Q, Gabriel G, Hoffman M et al. Uterine-sparing management of pyomyoma after uterine fibroid embolization. Radiol Case Rep 2019; 14 (8): 1031–5. DOI: 10.1016/j.radcr.2019.05.009
________________________________________________
2. Dyachenko D.T., Stepovaya A.M., Dobryagina S.A. To the question about etiopathogenesis of the uterine leyomi and new approaches to the treatment. Journal Bulletin of the Russian Military Medical Academy. 2019; 1 (S1): 142–5 (in Russian).
3. Lyutina K.V., Tyulkin R.V., Milchakov D.E. Gender changes in morbidity rate of benign hormone-dependent tumors in the first half of the 21st century. International research journal. 2017; 4–3: 166–9 (in Russian).
4. Tsareva S.N., Leshkovich A.S., Varigo N.V. Influence of pre-preparatory preparation on the course of pregnancy and delivery in women with myoma uterus. Medical Journal. 2020; 2: 115–7 (in Russian).
5. Fominova G.V., Lyalichkina N.A., Kosenko Y.Y. et al. During the gestational process and delivery in patients with uterine myoma. Modern problems of science and education. 2018; 4: 138 (in Russian).
6. Sheiner E, Bashiri A, Levy A et al. Obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas. J Reprod Med 2004; 49: 182e6.
7. Read S, Mullins J. Spontaneous Ruptured Pyomyoma in a Nulligravid Female: A Case Report and Review of the Literature. Case Rep Obstet Gynecol 2018; 2: 1026287. DOI: 10.1155/2018/1026287
8. Ono H, Kanematsu M, Kato H et al. MR imaging findings of uterine pyomyoma: radiologic-pathologic correlation. Abdominal Imaging 2014; 39 (4): 797–801.
9. Bagga R, Rai R, Kalra J et al. An Unusual Cause of Postabortal Fever Requiring Prompt Surgical Intervention: A Pyomyoma and its Imaging Features. Oman Med J 2017; 32 (1): 73–6. DOI: 10.5001/omj.2017.14
10. Greenspoon JS, Ault M, James BA et al. Pyomyoma associated with polymicrobial bacteremia and fatal septic shock: Case report and review of the literature. Obstet Gynecol Sur 1990; 45 (9): 563–69.
11. Iwahashi N, Mabuchi Y, Shiro M et al. Large uterine pyomyoma in a perimenopausal female: A case report and review of 50 reported cases in the literature. Molecular and Clinical Oncology 2016; 5 (5): 527–31. DOI: 10.3892/mco.2016.1005
12. Karcaaltincaba M, Sudakoff GS. CT of a ruptured pyomyoma. Am J Roentgenol 2003; 181 (5): 1375–77. DOI: 10.2214/ajr.181.5.1811375
13. Abulafia O, Shah T, Salame G et al. Sonographic features associated with post-uterine artery embolization pyomyoma. J Ultrasound Med 2010; 29 (5): 839–42. DOI: 10.7863/jum.2010.29.5.839
14. Chen ZHY, Tsai HD, Sun MJ. Pyomyoma: a rare and life-threatening complication of uterine leiomyoma. Taiwan J Obstet Gynecol 2010; 49 (3): 351–6.
15. Yeat S-K, Chong K-M, Pan H-S et al. Impending sepsis due to a ruptured pyomyoma with purulent peritonitis: a case report and literature review. Taiwan J Obstet Gynecol 2005; 44 (1): 75–9.
16. DeMaio A, Doyle M. Pyomyoma as a Rare Source of Postpartum Sepsis. Case Rep Obstet Gynecol 2015; 2015: 263518. DOI: 10.1155/2015/263518
17. Kaler M, Gailer R, Iskaros J et al. Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon. Case Rep Obstet Gynecol 2015; 2015: 609205. DOI: 10.1155/2015/609205
18. Shiota M, Kotani Y, Ami K et al. Uterus-sparing myomectomy for uterine pyomyoma following cesarean section. Taiwan J Obstet Gynecol 2013; 52 (1): 140–1.
19. Sirha R, Miskin A, Abdelmagied A. Postnatal pyomyoma: a diagnostic dilemma. BMJ Case Rep 2013; 2013: bcr2013201137. DOI: 10.1136/bcr-2013-201137
20. Yu Q, Gabriel G, Hoffman M et al. Uterine-sparing management of pyomyoma after uterine fibroid embolization. Radiol Case Rep 2019; 14 (8): 1031–5. DOI: 10.1016/j.radcr.2019.05.009
Авторы
Р.И. Габидуллина*1, М.А. Мингазетдинов2, Е.Б. Дружкова1, Л.И. Сирматова2
1 ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава
России, Казань, Россия;
2 ГАУЗ «Городская клиническая больница №7», Казань, Россия
*ru.gabidullina@yandex.ru
1 Kazan State Medical University, Kazan, Russia;
2 City Clinical Hospital №7, Kazan, Russia
*ru.gabidullina@yandex.ru
1 ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава
России, Казань, Россия;
2 ГАУЗ «Городская клиническая больница №7», Казань, Россия
*ru.gabidullina@yandex.ru
________________________________________________
1 Kazan State Medical University, Kazan, Russia;
2 City Clinical Hospital №7, Kazan, Russia
*ru.gabidullina@yandex.ru
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