2025 年第 9 期 第 20 卷

先天性宫颈憩室合并异常子宫出血1例并文献复习

Congenital cervical diverticulum combined with abnormal uterine bleeding: a case report and literature review

作者：贺玉垠程慧刘梦颖王晨叶明珠孙信

英文作者：He Yuyin Cheng Hui Liu Mengying Wang Chen Ye Mingzhu Sun Xin

单位：中南大学湘雅三医院妇科，长沙410000

英文单位：Department of Gynecology the Third Xiangya Hospital of Central South University Changsha 410000 China

关键词：先天性宫颈憩室；原发不孕；异常子宫出血；宫腹腔镜手术

英文关键词：Congenitalcervicaldiverticulum;Primaryinfertility;Abnormaluterinebleeding;Laparoscopicsurgery

• 摘要：

• 子宫憩室是一种罕见的子宫畸形，目前国内外文献报道极少，其临床表现缺乏特异性，易导致误诊或漏诊。本文通过1例典型病例探讨该病的诊断策略及个体化治疗模式。患者，32岁女性，以“经期延长2年余，阴道流血2个月”为主诉就诊。经阴道四维彩色多普勒超声及盆腔磁共振成像提示宫颈前壁似可见一处凹陷，宫腔镜检查进一步证实为宫颈管憩室。患者接受宫腹腔镜联合下的宫颈憩室切除术，术中完整切除憩室并修复宫颈肌层缺损。术后随访6个月，患者月经周期恢复正常。先天性宫颈憩室是一种罕见疾病，其临床症状缺乏特异性，需通过多模态影像学联合宫腔镜进行鉴别诊断。先天性宫颈憩室临床表现以异常子宫出血和不孕为主，易与其他妇科疾病混淆。建议结合影像学与腔镜检查实现精准诊断，并根据患者生育需求选择个体化手术方案。

• Uterine diverticulum is a rare uterine malformation, which is rarely reported in domestic and foreign literature. Its clinical manifestations lack specificity and can easily lead to misdiagnosis or missed diagnosis. This article explores the diagnostic strategy and individualized treatment mode of this disease through a typical case. The patient, a 32 year old female, presented with the main complaint of "prolonged menstrual period for more than 2 years and vaginal bleeding for 2 months". Transvaginal four-dimensional ultrasound and pelvic magnetic resonance imaging suggest a depression on the anterior wall of the cervix, which is further confirmed by hysteroscopy as cervical diverticulum. The patient underwent cervical diverticulectomy under laparoscopy, during which the diverticulum was completely removed and the cervical muscle layer defect was repaired. After a 6-month follow-up, the patient′s menstrual cycle returned to normal. Congenital cervical diverticulum is a rare disease with non-specific clinical symptoms that require differential diagnosis through multimodal imaging combined with hysteroscopy. Congenital cervical diverticulum is commonly characterized by abnormal uterine bleeding and infertility, which can be easily confused with other gynecological diseases. It is recommended to combine imaging and endoscopic examination to achieve accurate diagnosis, and choose personalized surgical plans based on the patient′s reproductive needs. This case provides important reference for clinical treatment of such rare diseases.