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患者37岁,已婚。从19岁开始每隔25～30天腹痛一次,持续3～4天,腹痛时有便意,呈进行性加重。22岁结婚,未作婚前检查。婚后可以性生活,但性交后精液外流,因周期性腹痛不缓解,当地医院行腹腔穿刺抽出血液后疼痛减轻来院。检查:耻骨联合上方可触及鸭卵大包块,中等硬,压痛明显。外阴发育正常,处女膜闭锁状,基底部向阴道方向延长,窥阴器可插入4cm左右,但中心部是一盲端,左侧可见一豆粒大紫蓝色结节,用探针不能由此探入,也未见其他孔道。三合诊盆腔内可触及超鹅卵大中等硬度之子宫,表面可触及结节感,活动受限,有压痛,双附件区增厚感,界限不清楚。B超可见宫体基本正常大小,有宫腔积液(血),子宫双侧可见轮廓不规则、回
Patient 37 years old, married. From the age of 19 every 25 to 30 days after the first abdominal pain, sustained 3 to 4 days, abdominal pain when there is meaning, was progressive increase. 22-year-old married, not before the marriage check. Sex can be married after marriage, but semen outflow after sexual intercourse, due to periodic abdominal pain does not ease, the local hospital abdominal paracentesis after the pain relief to the hospital. Check: pubic symphysis can reach the top of the large pieces of eggs, medium hard, tenderness significantly. Genital development is normal, the hymen is closed, the base of the vagina to extend the direction of the vagina can be inserted about 4cm, but the central part is a blind end, the left can be seen a large purple blue nodules, with the probe can not be explored Into, no other channel. Triad diagnosis of pelvic cavity can reach the medium and high hardness of the uterus, the surface can reach the nodules, limited mobility, tenderness, double attachment area thickened, the boundaries are not clear. B-normal visible Palace of the normal size, uterine fluid (blood), both sides of the uterus can be seen irregular outline, back