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Recurrent postmenopausal bleeding - just endometrial disease or ovarian sex cord-stromal tumor? A case report

World Journal of Clinical Cases 2022年第1期10卷 275-282页

作者： Jiao Wang Qing Yang Ning-Ning Zhang Dan-Dan Wang department of obstetrics and gynecology Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

BACKGROUND Postmenopausal bleeding(PMB)is a common gynecologic complaint among elderly women,and endometrial hyperplasia is a common cause of this *** fibromas are the most common type of ovarian sex cord-stromal tumor(sCsT).They arise from non-functioning stroma,rarely show estrogenic activity,and stimulate endometrial hyperplasia,causing abnormal vaginal *** sUMMARY We report herein the case of a 64-year-old Chinese woman who presented with recurrent PMB.A sex hormone test revealed that her estrogen level was significantly higher than normal,and other causes of hyperestrogenism had been *** patient had undergone four curettage and hysteroscopy procedures in the past 7 years due to recurrent PMB and endometrial *** culprit behind the increase in estrogen level—an ovarian cellular fibroma with estrogenic activity—was eventually found during the fifth *** Ovarian cellular fibromas occur insidiously,and some may have endocrine *** patients with recurrent PMB and endometrial thickening observed on ultrasonography are recommended to undergo sex hormone testing while waiting for results regarding the pathology of the *** the estrogen level remains elevated,the clinician should consider the possibility of an ovarian sCsT and follow-up the patient closely,even if the imaging results do not indicate ovarian *** the tumor is found,it should be removed as soon as possible no matter the size to avoid endometrial lesions due to long-term estrogen *** studies are needed to confirm whether preventive total hysterectomy with bilateral salpingo-oophorectomy should be recommended for women with recurrent PMB exhibiting elevated estrogen levels,despite the auxiliary examination results not indicating ovarian *** physical and psychological burden caused by repeated curettage could be prevented using this technique.

关键词： Postmenopausal bleeding Endometrial hyperplasia Estrogen excess Ovarian cellular fibroma Case report

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Post-marketing safety surveillance and reevaluation of Motherwort injection：A clinical study of 10094 cases

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Journal of Traditional Chinese Medicine 2018年第4期38卷 625-635页

作者： Cao shan Zhang Wenhao Zhao Ziwei Heng Mingli Bu Huaien Wang Hongwu Liu Xinghui Wang Zhong Cai Yan Ma Yuyan Cui shihong Deng Jihong Ding Guifeng Ding Yajuan Dong Linhong Duan Zhentao Fan Ling Fan Yang Fu Fen He Jing Ji shuying Jin Lin Li Hong Li Hongying Liao Tao Lu Wei Luo Xiucui Lü Zhihui Ma Fengchun Ma Dafeng shi Tianyun sun Juying sun Xiaotong Teng Hong Wang Jinhua Wang Ruihua Wang Ying Wang Zhengling Xi Jie Xu Minjuan Xu Zhihong Yan Qian Yang Cuirong Yang Yimei Yin Jie Yu Jinhua Yuan Wenjun Zhang Guanli Zhang Meihua Zhao Renfeng Zhong Yonghong Zhou Jian department of synopsis of Godden Chamber Hubei University of Chinese MedicineWuhan 430060China Chinese Internal Medicine Tianjin University of Traditional Chinese MedicineTianjin 300193China Chinese Preventive Medicine Tianjin University of Traditional Chinese MedicineTianjin 300193China department of Public Health Tianjin University of Traditional Chinese MedicineTianjin 300193China department of obstetrics West China Second University HospitalChengdu 610041China Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical sciences Beijing 100700China department of obstetrics The Fourth Hospital of Harbin Medical UniversityHarbin 150001China department of obstetrics Qilu Hospital of Shandong UniversityJinan 264001China department of obstetrics Maternal and Child Health Hospital of Henan ProvinceZhengzhou 450052China department of gynecology Kunming City Maternal and Child Health HospitalKunming 650021China department of obstetrics The First Affiliated Hospital of Guangxi University of Chinese MedicineNanning 530023China department of obstetrics and gynecology Dali Bai Autonomous Prefecture Maternal and Child HealthHospitalDali 671099China department of obstetrics Beijing Obstetrics andGynecology HospitalCapital Medical UniversityBeijing 100123China department of obstetrics and gynecology Ningxia People's HospitalYinchuan 750021China department of obstetrics and gynecology The Second Affiliated Hospital of Nan Chang UniversityNanchang 330006China department of obstetrics Women's HospitalSchool of Medicine Zhejiang UniversityHangzhou 310006China department of obstetrics Tang Shan City Mater-nal and Child Health Hospital of Tangshan 0633000China department of obstetrics Shiyan Maternal and Child Health HospitalShiyan 442000China department of gynecology Qujing No.1 HospitalQujing 655000China department of obstetrics Maternal and Child Health Hospital of LiuzhouLiuzhou 545001China department of obstetrics The First People's Hospital Of LianyungangLianyunga

OBJECTIVE:To investigate the safety profiles of Motherwort injection(MI).METHODs:A multi-center,prospective and drugderived hospital intensive monitoring method was conducted to assess the safety of MI in real world *** study was based on a very large population after the injection was approved and marketed in *** patients using the injection in participating hospitals were monitored to determine the incidence,pattern,severity and outcome of associated adverse ***:The post-marketing surveillance was performed in 10 094 female patients from April to December,*** incidence of adverse drug reactions(ADRs) was 0.79‰(8/10 094).Among the 8 patients,the reported adverse events mainly included systemic abnormalities,such as fever,chills and eyelid edema;skin and appendages disorders,such as pruritus and rash;gastrointestinal disorders,such as nausea,abdominal distension and pain;heart rate and rhythm disorders,such as palpitation and increased heart *** of these ADRs were mild in ***:In this study the ADRs incidence rate of MI is very low,which supports that it is generally safe for use in obstetric and gynecological ***,the total number of 8 ADRs recorded over a relatively short time span seems limited,and the low number of reports could not represent an absolute guarantee of safety.

关键词： safty Product surveillance postmarket-ing Drug-related side effects and adverse reac-tions Motherwort injection

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Uterine incision dehiscence 3 mo after cesarean section causing massive bleeding:A case report

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World Journal of Clinical Cases 2020年第11期8卷 2392-2398页

作者： Yao Zhang Ning-Ye Ma Xiao-Ao Pang department of obstetrics and gynecology Shengjing Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

BACKGROUND The traditional definition of late postpartum hemorrhage is a massive uterine hemorrhage from 24 h after delivery to the puerperal ***,we report a case of late postpartum hemorrhage that occurred 3 mo after cesarean section and endangered the patient's *** cause of the case we are reporting was poor incision *** reporting this case,we hope to make doctors aware that late postpartum hemorrhage due to poor incision healing may happen as late as 3 mo after cesarean *** sUMMARY A 31-year-old woman complained of acute,severe vaginal bleeding for 1 h;the patient had a history of cesarean section 3 mo *** receiving antiinflammatory treatment,fluid supplementation,blood transfusion,oxytocin administration,and hemostatic treatment,the vaginal bleeding ceased,and the patient’s clinical status ***,she experienced recurrent massive vaginal bleeding,and uterine contractile agents did not decrease the persistent *** save the patient’s life,she was admitted for emergency *** exploratory laparotomy,dehiscence and necrosis of the previous cesarean section scar were noted;the dehiscence penetrated through the entire thickness of the uterine muscle wall and extended to the left uterine ***,we performed a total *** Late postpartum hemorrhage due to poor incision healing after cesarean section may occur in the 3 mo after cesarean section or even ***,obstetricians-gynecologists should monitor for this potential complication in all patients post–cesarean *** hemorrhages can be severe enough to endanger the patient's life.

关键词： Cesarean section Late postpartum hemorrhage Pathogeny Prevention Treatment Wound healing Case report

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Uterine rupture in patients with a history of multiple curettages:Two case reports

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World Journal of Clinical Cases 2020年第24期8卷 6322-6329页

作者： Mei-Fang Deng Xiao-Di Zhang Qun-Feng Zhang Jue Liu department of obstetrics and gynecology The Second Affiliated Hospital of Nanhua UniversityHengyang 421001Hunan ProvinceChina

BACKGROUND Uterine rupture is a serious obstetric emergency,a severe event,and a serious threat to maternal and fetal *** is a rare and not well characterized by the fact that multiple operations of uterine cavities contribute to uterine rupture during *** uterine rupture is easily misdiagnosed as other obstetric or surgical *** current guidelines,abdominocentesis is a contraindication for late ***,the cases presented in this report provide new ideas for clinical diagnosis and treatment of uterine *** sUMMARY Case 1,a 34-year-old woman(gravida 5,para 2),32 wk and 4 d of gestation,presented with acute upper abdominal pain for 8 h with nausea and *** tomography(CT)revealed pelvic and abdominal *** extracted 3 mL unclotted blood from her abdominal *** emergency caesarean section was performed.A uterine rupture was found,and the fimbrial portion of the left fallopian tube was completely adhered to the *** prognosis of both the mother and the infant was *** 2,a 39-year-old woman(gravida 10,para 1)at 34 wk and 3 d of gestation complained of persistent lower abdominal pain for half a *** vital signs were *** revealed a high probability of pelvic and abdominal *** extracted 4 mL dark red blood without *** emergency laparotomy was *** rupture was identified during the *** course in both the mother and infant was *** For pregnant women in the second or the third trimester with persistent abdominal pain,abdominal effusion,fetal distress and even fetal death,the possibility of uterine rupture should be highly *** can identify acute abdominal surgical or gynecological and obstetric *** is helpful for diagnosing and clarifying the nature of effusion,but its clinical value need to be confirmed by further clinical studies.

关键词： Uterine rupture Clinical manifestations Early diagnosis Abdominocentesis Multiple curettages Case report

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Diffuse uterine leiomyomatosis: A case report and review of literature

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World Journal of Clinical Cases 2022年第24期10卷 8797-8804页

作者： Hui-Min Ren Qing-Zhu Wang Jia-Nan Wang Gang-Jie Hong shuang Zhou Jun-Yan Zhu shan-Ji Li department of gynecology Zhoushan Branch Ruijin HospitalShanghai Jiaotong University School of MedicineZhoushan 316000Zhejiang ProvinceChina department of obstetrics and gynecology Ningbo Hangzhou Bay HospitalNingbo 315336Zhejiang ProvinceChina department of Pathology Zhoushan Branch Ruijin HospitalShanghai Jiaotong University School of MedicineZhoushan 316000Zhejiang ProvinceChina department of obstetrics and gynecology Obstetrics and Gynecology HospitalFudan UniversityShanghai 200090China department of obstetrics and gynecology Renji HospitalShanghai Jiaotong University School of MedicineShanghai 200127China

BACKGROUND Diffuse uterine leiomyomatosis(DUL)is a benign uterine smooth muscle neoplasm with unknown *** DUL is rarely reported,knowledge regarding it is *** rate of early diagnosis is low,and DUL is often misdiagnosed as common multiple uterine leiomyomas before *** sUMMARY A 27-year-old patient with no sexual activity presented to the Emergency department of our hospital complaining of heavy vaginal *** had a history of uterine fibroids and *** examination showed a regularly enlarged uterus,similar in size to that associated with a 4-mo *** magnetic resonance imaging(MRI)revealed numerous multiple uterine fibroids,and a transabdominal myomectomy(TM)was *** exploration revealed that the myometrium was full of myoma nodules of variable *** 50 leiomyomas were *** pathology report confirmed *** patient was discharged and received a gonadotropin-releasing hormone analog(3.75 mg)for 6 *** months after surgery,the patient presented to the hospital again for abnormal uterine *** showed an irregular mass with a diameter of 5.2 cm without sharp demarcation in the uterine *** leiomyoma was considered first,and the patient underwent a hysteroscopic myomectomy plus hymen *** exploration showed that there were several leiomyomatosis masses in the *** pathological exam-ination confirmed submucosal leiomyoma and necrotic and generative *** the menstrual cycle was still irregular,the patient did not have symptoms of menorrhagia for a period of 28 mo after the second *** Individuals with DUL are easily misdiagnosed due to the lack of specific manifestations of this *** is helpful for early identification and preoperative *** is currently no unified method of *** women who want to preserve fertility,conservative surgery should be made an *** TM is

关键词： Diffuse uterine leiomyomatosis Leiomyoma Myomectomy Uterine-sparing surgery Case report

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Combined Detection of serum Matrix Metalloproteinase 9,Acetyl Heparinase and Cathepsin L in Diagnosis of Ovarian Cancer

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Chinese Journal of Cancer Research 2012年第1期24卷 67-71页

作者： Wei Zhang Xiao-xia Hu Xing-zhi Yang Qi Wang Hong Cheng shu-mei Wang Yan-ling Hu Zhi-jun Yang Li Li department of Gynecologic Oncology Cancer Institute and HospitalGuangxi Medical UniversityNanning 530021China department of gynecology and obstetrics the People's Hospital of Guangxi ProvinceNanning 530022China

Objective： To investigate the clinic values of combining test of serum matrix metalloproteinase 9 （MMP-9）, acetyl heparinase （Hpa） and Cathepsin L （CL） in diagnosis of ovarian cancer. Methods： serum levels of MMP-9, Hpa and CL were detected in a total of 418 cases, including 217 cases with ovarian malignant tumor, 100 cases with ovarian benign tumor and 101 healthy controls, by using enzyme-linked immunosorbent assay （ELIsA）. Their correlation with clinicopathologic feature of ovarian malignant tumor was analyzed and their diagnosis performance was evaluated by receiver operating characteristic （ROC）. The combined diagnosis model was established by logistic regression analysis. Results： The serum levels of MMP-9, Hpa and CL were significantly higher in patients with ovarian malignant tumor than in benign tumor and healthy control, the serum levels of CL and Hpa were higher in epithelial cancer than in non-epithelial tumor, and MMP-9, Hpa and CL were elevated in low grade and advanced stage compared to high grade and early stage. The sensitivity for diagnosis of ovarian malignant tumor from high to low was CL, Hpa and MMP-9, and the specificity was MMP-9, CL and Hpa. The united diagnosis model was established and showed the sensitivity and specificity of combined detection were 84.6% and 82.1%, respectively, which were significantly higher than a single tumor marker. Conclusion： serum MMP-9, Hpa and CL were correlated with ovarian malignant tumor and the combined detection of which may be valuable for clinical diagnosis of ovarian malignant tumor.

关键词： Ovarian cancer Matrix metalloproteinase 9 Acetyl heparinase Cathepsin Diagnosis

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Efficacy and safety of sanjie Analgesic Capsule in Patients with Endometriosis-Associated Pain:A Multicenter,3:1 Randomized,Double-Blind,Placebo-Controlled Trial

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Chinese Journal of Integrative Medicine 2024年第9期30卷 780-787页

作者： LENG Jin-hua DUAN Hua GUAN Zheng ZHOU Ying-fang QU Hong XU Kai-hong ZHANG shao-fen ZHANG Qin WANG Xin LIN Kai-qing LANG Jing-he department of obstetrics and gynecology Peking Union Medical College HospitalBeijing100730China department of gynecology Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing100006China department of gynecology Chinese PLA General HospitalBeijing100039China department of gynecology Peking University First HospitalBeijing100034China department of gynecology Beijing Chao-yang HospitalBeijing100020China department of gynecology Womens Hospital School of Medicine Zhejiang UniversityHangzhouZhejiang Province310006China department of gynecology Obstetrics and Gynecology Hospital of Fudan UniversityShanghai200090China department of gynecology Hangzhou Hospital of Traditional Chinese MedicineHangzhou310007China department of gynecology Affiliated Hospital of Liaoning University of Traditional Chinese MedicineShenyang110032China

Objective:To assess the efficacy and safety of sanjie Analgesic Capsule(sAC)in Chinese patients with endometriosis-associated ***:This was a multicenter,randomized,double-blind,placebo-controlled trial conducted at 15 centers between November 2013 and July 2017 in *** 323 patients with endometriosis were randomized at a 3:1 ratio to the sAC group(241 cases)and placebo group(82 cases)by stratified block *** in the sAC or placebo groups were given sAC or placebo 1.6 g 3 times per day,orally,respectively since the first day of menstruation for 3 consecutive menstrual *** primary endpoint was clinical response to dysmenorrhea evaluated using a 10-point Visual Analogue scale at 3 and 6 *** secondary endpoint was the pain score evaluated by VAs(chronic pelvic pain,defecation pain,and dyspareunia)at 3 and 6 months,and the pain recurrence rate at 6 *** events(AEs)were recorded during the ***:A total of 241 women were included in the sAC group,and 82 were in the placebo *** these women,217(90.0%)and 71(86.6%)completed the intervention,*** 3 months,overall response rate(ORR)was significantly higher in women administered sAC(80.1%)compared with those who received a placebo(30.5%,Psix months after treatment,the ORR for dysmenorrhea was 62.7%in the sAC group and 31.7%in the placebo group(Psignificantly improved by sAC compared with placebo(both Ps of total AEs events in the sAC and placebo groups were 6.6%and 9.8%,respectively,and no significant difference was shown between the two groups(P=0.339).Conclusion:sAC is well-tolerated and may improve dysmenorrhea in women with endometriosis-associated pain.

关键词： endometriosis pain sanjie Analgesic Capsule randomized controlled trial Chinese medicine

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Preparation method of an ideal model of multiple organ injury of rat with severe acute pancreatitis

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World Journal of Gastroenterology 2007年第34期13卷 4566-4573页

作者： Xi-Ping Zhang Qian Ye Xin-Ge Jiang Mei-Li Ma Fei-Bo Zhu Rui-Ping Zhang Qi-Hui Cheng epartment of General surgery Hangzhou First People's Hospital Hangzhou 310006 Zhejiang Province China Zhejiang University of Traditional Chinese Medicine Hangzhou 310053Zhejiang Province China First Affiliated hospital Shanxi Medical University Taiyuan 030001 Shanxi Province China department of Gynaecology and obstetrics Hangzhou First People's Hospital Hangzhou 310006 ZhejiangProvince China

AIM： To establish an ideal model of multiple organ injury of rats with severe acute pancreatitis （sAP）.METHODs： sAP models were induced by retrograde injection of 0.1 mL/100 g 3.5% sodium taurocholate into the biliopancreatic duct of sprague-Dawley rats. The plasma and samples of multiple organ tissues of rats were collected at 3, 6 and 12 h after modeling. The ascites volume, ascites/body weight ratio, and contents of amylase, endotoxin, endothelin-1 （ET-1）, nitrogen monoxidum （NO）, phospholipase A2 （PLA2）, tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） in plasma were determined. The histological changes of multiple organs were observed under light microscope.REsULTs： The ascites volume, ascites/body weight ratio, and contents of various inflammatory mediators in blood were higher in the model group than in the sham operation group at all time points [2.38 （1.10）, 2.58 （0.70）, 2.54 （0.71） vs 0.20 （0.04）, 0.30 （0.30）, 0.22 （0.10） at 3, 6 and 12 h in ascites/body weight ratio; 1582 （284）, 1769 （362）, 1618 （302）（U/L） vs 5303 （1373）, 6276 （1029）, 7538 （2934）（U/L） at 3, 6 and 12 h in Amylase; 0.016 （0.005）, 0.016 （0.010）, 0.014 （0.015）（EU/mL） vs 0,053 （0.029）, 0.059 （0.037）, 0.060 （0.022）（EU/mL） at 3, 6 and 12 h in Endotoxin; 3.900 （3.200）, 4.000 （1.700）, 5.300 （3.000）（ng/L） vs 41.438 （37.721）, 92.151 （23.119）, 65.016 （26.806）（ng/L） at 3, 6 and 12 h in TNF-α, all P 〈 0.01]. Visible congestion, edema and lamellar necrosis and massive leukocytic infiltration were found in the pancreas of rats of model group. There were also pathological changes of lung, liver, kidney, ileum, lymphonode, thymus, myocardium and brain.CONCLUsION： This rat model features reliability, convenience and a high achievement ratio. Complicated with multiple organ injury, it is an ideal animal model of sAR

关键词： severe acute pancreatitis Multiple organs Injury Animal model Rats Inflammatory mediator

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Clinial Implication of tThe Expression of Aurora B in Normal Endometrium and Endometrial Carcinoma

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Journal of Huazhong University of science and Technology(Medical sciences) 2008年第3期28卷 337-339页

作者：黎普茜周倩珺任利容肖兰 department of obstetrics and gynecology The People's Hospital of Dongguan department of obstetrics and gynecology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology

The expression of Aurora B in normal endometria and endometrial carcinomas and its relation with clinicopathologic parameters of endometrial carcinomas were investigated. streptavidin-biotin peroxidase （sP） immunohistochemical technique was used to detect the expression of Aurora B in 10 cases of normal proliferative phase endometria, 10 cases of normal secretory phase endometria and 72 cases of endometrial carcinomas respectively. According to the 1988 International Federation of gynecology and obstetrics （FIGO） grade, there were 37 patients in grade 1, 23 in grade 2 and 12 in grade 3 respectively. According to the FIGO stage, there were 59 patients in stage Ⅰ-Ⅱ and 13 patients in stage Ⅲ-Ⅳ. Aurora B was expressed in both normal proliferative phase endometria, secretory phase endometria and endometrial carcinomas, but its positive labeling index （PLI） in proliferative phase endometria was significantly higher than that in secretory phase endometria （P〈0.01） and endometrial carcinomas （P〈0.01）. The PLI of Aurora B was lower in tumors with well differentiation （G1）, low surgical staging （Ⅰ-Ⅱ）, and ≤1/2 myometrial invasion than that in tumors with moderate and low differentiation （G2--G3）, higher surgical staging （Ⅲ-Ⅳ）, and 〉1/2 myometrial invasion （all P〈0.01）. Aurora B exerts its functions in the replication of normal endometrial glandular cells; Expression of Aurora B is significantly correlated with biologic behavior of endometrial carcinoma, indicating that Aurora B may be a promising prognostic factor in endometrial carcinoma.

关键词： endometrium endometrial carcinoma Aurora B immunohistochemistry

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Ultrasound diagnosis of congenital Morgagni hernias: Ten years of experience at two Chinese centers

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World Journal of Clinical Cases 2024年第3期12卷 495-502页

作者： Hui-Qing shi Wen-Juan Chen Qiang Yin Xue-Hua Zhang department of Ultrasound Fujian Children’s Hospital(Fujian Branch of Shanghai Children’s Medical Center)College of Clinical Medicine for Obstetrics&Gynecology and PediatricsFujian Medical UniversityFuzhou 350011Fujian ProvinceChina department of Ultrasound Hunan Children’s HospitalUniversity of South ChinaChangsha 410007Hunan ProvinceChina department of Pediatric surgery Hunan Children’s HospitalUniversity of South ChinaChangsha 410007Hunan ProvinceChina

BACKGROUND Morgagni hernias are rare anomalies that are easily misdiagnosed or *** To summarize the ultrasound(Us)imaging characteristics of Morgagni hernias through a comparison of imaging and surgical *** The records of children with Morgagni hernias who were hospitalized at two hospitals between January 2013 and November 2023 were retrospectively re-viewed in terms of clinical findings,Us features,and operative *** Between 2013 and 2023,we observed nine(five male and four female)children with Morgagni *** abdominal scanning revealed a widening of the prehepatic space,with an abnormal channel extending from the xiphoid process to the right or left side of the thoracic *** channel had intestinal duct and intestinal gas *** contents were found in the transverse colon(n=6),the colon and small intestine(n=2),and the colon and stomach(n=1).Among the patients,seven had a right-sided lesion,two had a left-sided lesion,and all of them had hernial *** Us imaging can accurately determine the location,extent,and content of Morgagni *** suspected Mor-gagni hernias,we recommend performing sonographic screening first.

关键词： children Congenital diaphragmatic hernias Morgagni hernia Operation Ultrasound Gastrointestinal imaging

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