産褥性子宮内反症の診断にCTが有用であった1例

Puerperal uterine inversion diagnosed via computed tomography：a case report

産褥期の子宮内反症は分娩直後の強烈な疼痛と大量出血をきたし，神経因性・出血性ショックをきたす迅速な診断および治療が必要な産科救急疾患である。通常，身体所見や超音波検査で診断され即座に整復術が施行され，また大量出血やショック状態からCTおよびMRI検査が施行される頻度が低く，画像所見の報告が少ない。しかし，不全子宮内反症ではときにベッドサイドでの診断が困難な場合がある。

A Japanese woman in her twenties presented with bleeding after having undergone repositioning of an inverted uterus previously. She had anemia, low blood pressure, and tachycardia；however, the cause of the bleeding could not be identified via bedside examinations. Contrast enhanced computed tomography（CT）revealed that the uterus was deformed into a heart shape, confirming recurrence of uterine inversion. Occasionally, when incomplete uterine inversion is difficult to diagnose at the bedside, CT can be used for diagnosis.