阴道斜隔综合征超声误诊原因分析

Misdiagnosed Causes of Oblique Vaginal Septum Syndrome by Ultrasound

目的探讨阴道斜隔综合征超声误诊原因,提高超声医师对该病的认识。方法回顾分析2014—2021年经手术病理确诊的4例阴道斜隔综合征的超声及临床资料。结果本组1例因阴道异常分泌物就诊,2例因进行性痛经就诊,1例因体检发现盆腔包块就诊。4例超声首诊全部误诊,误诊率为100%。其中1例误诊为阴道壁囊肿合并完全性纵隔子宫,2例误诊为子宫内膜异位囊肿合并双子宫双宫颈畸形,1例误诊为盆腔包块合并完全性纵隔子宫。4例均发现合并子宫畸形,并梗阻侧肾脏发育异常,均经手术、病理证实为阴道斜隔综合征。4例手术顺利,无手术并发症,术后阴道异常分泌物和(或)痛经等症状消失。结论阴道斜隔综合征临床罕见,避免误诊需提高超声医师对本病的认识,当青少年阴道包块合并子宫畸形就诊时,需想到本病可能并加以鉴别,同时检查泌尿系统超声。

Objective To explore misdiagnosed causes of oblique vaginal septum syndrome(OVSS)by ultrasound and to improve the understanding of ultrasonic doctors.Methods The ultrasonic and clinical data of 4 patients with OVSS diagnosed by surgery and pathological results from 2014 to 2021 was retrospectively analyzed.Results In this group,1 patient visited the doctor for abnormal vaginal secretions,and 2 patients for progressive dysmenorrhea and 1 for pelvic mass found in physical examination.The 4 patients were misdiagnosed by ultrasound initially,and the misdiagnosed rate was 100%.Among the 4 patients,there were 1 patient misdiagnosed as having vaginal wall cyst combined with complete mediastinal uterus,2 as having endometriosis cyst combined with double uterus and double cervix malformation,and 1 as having pelvic mass combined with complete mediastinal uterus.Complicated by uterine malformation and abnormal renal development on the obstructive side were found in the 4 patients,and then OVSS was confirmed by operation and pathological results.The operation was successful without surgical complications in 4 patients.The symptoms of abnormal vaginal secretions and/or dysmenorrhea disappeared after operation.Conclusion OVSS is rare in clinic.Ultrasound doctors need to improve their understanding of the disease in order to avoid misdiagnosis.When teenagers have vaginal mass combined with uterine malformation,the possibility of OVSS should be suspected and identified,and ultrasound of urinary system should be performed simultaneouly.