دانلود رایگان مقاله انگلیسی تب و درد کشاله ران در زنان بزرگسال - الزویر 2018

CASE REPORT A 47-year-old woman with known uterine myoma presented with a complaint of fever and groin pain radiating to the buttocks for 4 days. Her initial vital signs showed a blood pressure of 105/72 mm Hg, pulse rate of 72 beats/ min, and oral temperature of 38.6C (101.48F). Physical examination revealed a firm, irregular pelvic mass, without tenderness. The pelvic examination result was unremarkable. Laboratory testing revealed a white blood cell count of 11,800 cells/mL, C-reactive protein level of 113 mg/L, and lactate dehydrogenase level of 1103 IU/L. Contrast-enhanced computed tomography (CT) of the pelvis showed an intramural fibroid with peripheral enhancement surrounding the central hypodense lesion and uterine lumen (Figure 1). The patient was treated with hysterectomy and bilateral salpingo-oophorectomy, in which the diagnosis of red degeneration of uterine leiomyoma was confirmed by the typical pathological feature of intramural fibroid (Figure 2).

DISCUSSION

Red degeneration of uterine leiomyoma is a subtype of uterine fibrinoid degeneration, including hyaline, cystic, myxoid, and red (1). It can present as an acute abdominal pain with low-grade fever, occurring in 8% of tumors complicating pregnancy and 3% of all uterine leiomyomas (2,3). The name is derived from its beefy red color due to the coagulative necrosis indicating the presence of abundant thrombosed vessels at the periphery of the lesion caused by simultaneous and abrupt shutting off of the drainage veins (4).