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Retroperiton

 
Goubaa Mohamed MD Djerba Tunisia

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This is a 43-year-old female with history of infertility. The patient also complained constipation and increasing abdominal girth. An ultrasound study was performed. Voici le cas d'une patiente de 43 ans avec une histoire de stérilité primaire. Elle se plaint de constipation et d'une distension abdominale. Un examen échographique a été pratiquée.

 

Transvaginal sonography Echographie endovaginale

definitive treatment is hysterectomy : the removed mass : En Chirurgie: hystérectomie et ablation d'un gros utérus en boule.

The follow-up study : 2 years later : only the cervix Contrôle : 2 ans plus tard

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2 years later
2 ans plus tard
A15-cm solid mass is seen above the bladder. The mass abuts the uterine fundus (Scan 1) but is not separate from the uterus (Scan 2 : transvaginal scanning). Here, It is difficult to tell the difference between adenomyosis and fibroids. Adenomyosis were confirmed by pathologic examination.
Abdominal hysterectomy were performed. The postoperative period of the patient was uneventful.
Conclusion:
Extreme enlargement of the uterus is possible due to adenomyosis alone (1).

Masse solide de 15 cm est visible au dessus de la vessie (cliché 1). la masse est au dépend de l'utérus et c'est visible par échographie endovaginale (cliché 2). Ici, il est difficile de différencier, ici, entre une fibrome et une adénomyose utérine. L'étude anatomopathologique confirme l'adénomyose.
Conclusion :
l'élargissement important de l'utérus peut avoir comme unique cause l'adénomyose.
Adenomyosis Adénomyose Utérine _______________

 

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Références:
1: Gynecol Obstet Invest. 2004 Aug 24;58(4):216-218. A Case of Adenomyosis per se with a Uterine Weight of 475 g. Harmanli OH, Shen T, Zhu S, Chatwani AJ. Department of Obstetrics and Gynecology, Temple University School of Medicine, Philadelphia, Pa., USA.
2: Clin Radiol. 2004 Jun;59(6):520-6. Uterine artery embolization for adenomyosis without fibroids. Kim MD, Won JW, Lee DY, Ahn CS. Diagnostic Radiology, Bundang CHA General Hospital, Pochon CHA University, 351 Yatap-dong, Bundang-gu, Sungnam-si, Kyonggi-do, Sungnam, South Korea. mdkim@cha.ac.kr
3: Ultrasound Obstet Gynecol. 2002 Dec;20(6):605-11. Comment in: Ultrasound Obstet Gynecol. 2003 Jun;21(6):626-7. Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation. Bazot M, Darai E, Rouger J, Detchev R, Cortez A, Uzan S. Department of Radiology, Hopital Tenon, Paris, France. marc.bazot@tnn.ap-hop-paris.fr
4: AJR Am J Roentgenol. 2002 Aug;179(2):379-83. Sonographic findings in patients with adenomyosis: can sonography assist in predicting extent of disease? Hulka CA, Hall DA, McCarthy K, Simeone J. Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
5: Tunis Med. 2001 Aug-Sep;79(8-9):447-51. [Adenomyosis: analysis of 35 cases] Ben Aissia N, Berriri H, Gara F. Service de gynecologie-obstetrique, CHU Mongi Slim La Marsa.
6: Hum Reprod. 2001 Nov;16(11):2427-33. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Bazot M, Cortez A, Darai E, Rouger J, Chopier J, Antoine JM, Uzan S. Department of Radiology, Hopital Tenon, 4 rue de la Chine, 75020, France. marc.bazot@tnn.ap-hop-paris.fr
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15: Akush Ginekol (Mosk). 1994;(2):40-3. [A clinico-morphological comparison of the ultrasonic criteria of adenomyosis] [Article in Russian] Damirov MM, Bakuleva LP, Shabanov AM, Sliusar' NN.
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