miomatosis uterina
DESCRIPTION
miomatosis uterina giganteTRANSCRIPT
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ÓRGANOS INTERNOS
Ovarios
Trompas de Falopio
Útero
vagina
ÓRGANOS
EXTERNOS
Clítoris
Labios
Monte de Venus
Vestíbulo Vulvar
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Tumores benignos que se originan en células
musculares y que contienen además tejido
fibroso.
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1 de cada 4 mujeres enedad reproductiva enla 3ra y 4ta década dela vida
Son muy raros antesde los 20 años.
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Son más comunes en la
raza negra (50% vs. 25%)
Más frecuentes en
mujeres nulíparas o
infértiles
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LOCALIZACION
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SUBMUCOSO
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INTRAMURAL
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SUBSEROSO
Sésiles
Pediculados
Migratorios
interligamentarios
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Alteraciones menstruales (el mioma intramural es el
que más sangra)
tumoración abdominal palpable
dolor tipo pesadez
flujo vaginal
molestias de compresión
esterilidad e infertilidad
síntoma secundario: ANEMIA
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ECOGRAFIA PELVICA O TRANSVAGINAL
EXAMEN PELVICO
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ULTRASONOGRAFÍA
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LAPAROSCOPÍA
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BIOPSIA
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HISTERECTOMIA
VIDEO
LAPAROSCOPICAHTA
MIOMECTOMIA
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BASADO EN
su estado general
de salud
que tan
avanzada está
la condición
sus deseos
acerca
del embarazo
su opinión o
preferencia
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HTA TOTAL HTA SUBTOTAL
HTA TOTAL +
SALPINGO-
OFORECTOMIA UNI O
BILATERAL
HTA AMÇPLIADA HTA RADICAL
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Histerectomía
Miomectomia
(cirugía mínimamente invasiva)
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MOTIVO DE CONSULTA
MC Y EA: paciente que consulta con impresiónclinica de miomatosis uterina programada paracirugía
ANTECEDENTES PERSONALES: alergiarespiratoria
ANTECEDENTES QUIRURGICOS:
miomectomía anterior (sin datos) cesáreas 2
CANCER MAMARIO (sin datos)
GRUPO SANGUINEO: O RH +
ANTECEDENTES GINECOLOGICOS
: G2-P0-C2-A0
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EXAMEN FISICO: consciente, orientadaSIGNOS VITALES: ta 150/90 fc 108x’CCC: clinicamente normalOJOS: clinicamente normalORL: clinicamente normalCUELLO: clinicamente normalTORAX: ruidos cardíacos bien timbrados
HISTORIA CLINICA DE CONSULTA EXTERNA
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ABDOMEN: globoso pormiomatosis con palpación de masaGU: no se exploroEXTREMIDADES: cnNEUROLOGICOS: cnIDX miomatosis uterina
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EXAMENES DE LABORATORIOS
trae RX de tórax: dentro
de limites normales
histerometria: útero
aumentado de tamaño,
globoso, con endométrio
lineal en su interior.
diâmetro longitudinal:
108 mm
diâmetro posterior:
51mm
diâmetro transverso:
70MM
ovario derecho mide 27mm x
22mm
ovario izquierdo: mide 32mmx
27mm
ambos ovarios son de tamaño,
contorno y ecogenesidad normal
no se aprecian masas pélvicas
conclusión: útero miohiperplasico
estúdio citológico cervicouterina,
negativa para LESION
INTRAEPITELIAL O
MALIGNIDAD
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CANASTA DE HISTERECTOMIA
CANASTA DE LAPAROTOMIAseparador de
sullivan
Valvas
maleables
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paciente valorada por medicina interna yanestesiología para procedimiento quirúrgico.
se realiza el ingreso de la paciente a la sala decirugía.
se procede a realizar el acto anestésico con bloqueosubaracnoideos (profesor barros pimienta).
se realiza la asepsia y antisepsia del campooperatorio.
se inicia el procedimiento quirúrgico propuestohisterectomía abdominal
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INCISION MEDIANA INFRAUMBILICAL
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EXPOSICION DEL UTERO
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EXTRACCION DEL UTERO
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MUESTRA PATOLOGICA
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Peso del útero 9 kilos
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PREPARACION DE LA MUESTRA
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EXCELENTES CONDICIONES GENERALES DE LA PACIENTE
A LOS 20 DIAS SE REINTEGRO A SU TRABAJO
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