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Abstract: The patient presented with a small amount of vaginal bleeding and recent blood in urine. Pelvic ultrasonography showed a mass in the uterus, a small amount of fluid in the pelvis, and a mass with mixed signals in the left uterine cavity with abundant blood flow around the mass in a cystic shape, involving the nearby myometrium, but no embryonic tissue was present, and the diagnosis was complete chylothorax. The patient was operated hysteroscopically to clear the uterus. The operation was successful, and the patient’s vaginal bleeding stopped and the symptoms of blood in urine disappeared.
Basic information】Female, 32 years old
Type of disease】Complete staphyloma
Hospital】Shengjing Hospital of China Medical University
Date of Consultation】January 2022
Treatment plan】Surgical treatment (ultrasound-guided uterine curettage)
Treatment Period】1 week in hospital
Results】The swelling in the uterus disappeared, vaginal bleeding stopped, and blood in the urine disappeared.
I. Initial consultation
The patient was pale and weak at the time of consultation. She complained that her menstruation had been stopped for 1 month, and her own test at home showed positive, but there had been a small amount of vaginal bleeding, and she thought it was because her menstruation had not cleared. The patient was admitted to the hospital for treatment.
II. Treatment process
The pelvic ultrasonography showed a mass in the uterus and a small amount of fluid in the pelvic cavity, but no other abnormalities were found, which could exclude ectopic pregnancy.
The patient underwent ultrasound-guided curettage, and the postoperative tissue was sent to pathology, which showed that the patient was indeed a complete gravida.
III. Treatment results
The patient had a small amount of vaginal bleeding and blood in the urine due to complete staphyloma. After the operation to remove the diseased tissue, the swelling in the uterus disappeared, the vaginal bleeding stopped and the pain was relieved. One week after the operation, the patient’s body temperature was normal, her diet and sleep were normal, and the symptoms of blood in urine disappeared. The postoperative examination showed that the mass in the uterine cavity disappeared and there was no more fluid in the pelvic cavity, and the patient was in a good mental state with a rosy complexion and no other complications.
IV. Precautions
I was very happy for the patient, and told her to pay attention to vulva cleanliness after discharge, wash her vulva every day, not to have sex for a short time, and to pay attention to a light diet, eat more fresh vegetables and fruits, avoid spicy and stimulating foods, and eat more protein-rich and high-fiber foods to promote her body’s recovery. In addition, within 2 years after the operation, the patient should do a good job of contraception to avoid another pregnancy leading to the recurrence of complete staphyloma, and if there are any uncomfortable symptoms during the period again, you must go to the hospital in time.
V. Personal insight
The patient initially thought she had a normal pregnancy and did not pay attention to it until she had symptoms of blood in urine, but after the operation to remove the diseased tissue, the patient’s vaginal bleeding disappeared and the pain was relieved. She was told to take care of her recuperation after discharge and to pay attention to the examination of her next pregnancy without worrying too much.