2004, Number 6
<< Back Next >>
Cir Cir 2004; 72 (6)
Uterine avulsion by blunt abdomino-pelvic trauma
Ortiz-Mendoza CM, Fernández-Carreño AJ
Language: Spanish
References: 15
Page: 499-502
PDF size: 72.30 Kb.
ABSTRACT
Objective: Our objective was to present a case of uterine avulsion due to blunt trauma.
Clinical case: A 40-year-old female with diabetes mellitus and chronic renal failure was run over by a truck resulting in an unstable pelvic fracture. She was submitted to external pelvic fixation, but for homodynamic instability a diagnostic peritoneal lavage was done with resulting macroscopic blood. A laparotomy was done and a uterine avulsion was found in the union of the isthmus and corpus. A subtotal hysterectomy was performed and the pelvis was also packed due to damage of the sacral plexus.
Results: The patient survived the pelvic and genital injuries but died 14 days after the initial surgery due to renal failure.
Conclusions: Uterine avulsion is an infrequent but potentially lethal lesion associated with complex pelvic fractures.
REFERENCES
Dirección General de Estadística e Informática de la Secretaría de Salud. Principales resultados de la estadística sobre mortalidad en México, 1999. Salud Publica Mex 2001;43:67-73.
Knudson MM, Rozycki GS, Stear CM. Reproductive system trauma. In: Mattox KL, Feliciano DV, Moore EE, editors. Trauma. 4th ed. McGraw-Hill International; 2000. pp. 879-905.
Stone NN, Ances IG, Brotman S. Gynecologic injury in the nongravid female during blunt abdominal trauma. J Trauma 1984;24:626-627.
Hijar-Medina M, Ortega-Mejía L, Dimas-García M. Traumatismos y envenenamientos como causas de demanda de servicios de urgencia. Salud Publica Mex 1989;31:447-468.
Meneses-González F, Rea R, Ruiz-Matus C, Hernández-Ávila M. Accidentes y lesiones en cuatro hospitales generales del Distrito Federal. Salud Publica Mex 1993;35:448-455.
Illescas FGJ. Epidemiología del trauma en la ciudad de México. Trauma 2003;6:40-43.
Arreola-Pissa C, Herrera EAJ, de la Cruz O, Mock CN. Análisis de la mortalidad por accidentes viales en la ciudad de Monterrey. Qué hemos aprendido y estrategias a implementar. Trauma 2003;6:4-14.
Fanghänel-Salmon G, Sánchez-Reyes L, Arellano-Montaño S, Valdés-Liaz E, Chavira-López J, Rascón-Pacheco RA. Prevalencia de factores de riesgo de enfermedad coronaria en trabajadores del Hospital General de México. Salud Publica Mex 1997;39:427-432.
Escobedo-de-la-Peña J, Islas J, Lifshitz-Guinzberg A, Méndez JD, Revilla C, Vázquez-Estupiñán F. Higher prevalence of diabetes in hypertensive subjects with upper body fat distribution. Rev Invest Clin 1998;50:5-12.
Hunter JC, Brandeser EA, Tran KA. Pelvic and acetabular trauma. Radiol Clin North Am 1997;35:559-590.
Scalea TM, Burgess AR. Pelvic fractures. In: Mattox KL, Feliciano DV, Moore EE, editors. Trauma. 4th ed. McGraw-Hill International; 2000. pp. 807-837.
Zhou SR. Fractures-dislocation of pelvis in the adult female: clinical analysis of 105 cases. Zhonghua Wai Ke Za Zhi 1989;27:479-481.
Smith RJ. Avulsion of the nongravid uterus due to pelvic fracture. South Med J 1989;82:70-73.
Donner GG, Pel M, Lammes FB. Primary amenorrhea caused by crushing trauma of the pelvis. Am J Obstet Gynecol 2000;183:500-501.
Doman AN, Koekstra DV. Pelvic fractures associated with severe intra-abdominal gynecologic injury. J Trauma 1988;28:18-20.