Myoma node necrosis: when uterine fibroids threaten your life

Uterine fibroids are one of the most widespread gynecological pathologies. This benign tumor of the internal genital organs often develops in women of reproductive age, significantly affecting the quality of life of patients. In addition to serious violations of the reproductive function, uterine fibroids can also cause the development of an extremely dangerous condition: acute abdomen syndrome. Approximately 7% of patients with uterine fibroids develop necrosis of the myoma node - a dangerous complication of the disease, which, if not treated promptly, can lead to irreversible consequences. The characteristic clinical picture and modern diagnostic methods will help to recognize and cure the pathology.

Clinical picture and methods of treatment for necrosis of the myomatous node

Necrosis of the myomatous node is a dangerous complication of uterine fibroids, which develops against the background of impaired blood supply to a benign formation and is characterized by the development of necrotic processes in its tissues. The cause of impaired blood supply to the node may be insufficient vascularization of the tumor or torsion of its legs. Most often, the pathology develops during pregnancy, in the postpartum or post-abortion period, since during these periods blood flow in the myometrium decreases, vascular tone increases and venous outflow is disturbed. These changes create a favorable background for the development of necrotic processes in the tissues of the myomatous node.

Necrosis of myomatous node:

• clinical picture with necrosis of the myomatous node;
• diagnostic algorithm for necrosis of the myomatous node;
• methods of treatment for necrosis of the myomatous node.

Clinical picture in necrosis of the myomatous node

The clinical picture that occurs with necrosis of the myomatous node directly depends on what etiological factor provoked the development of such a process. Torsion of the pedicle of the tumor formation occurs spontaneously, as a result of which the following symptoms of the pathology are acutely manifested:

• severe pain in the lower abdomen;
• chills;
• nausea and vomiting;
• dry mouth;
• Intestinal disorders.

If necrotic processes develop against the background of insufficient vascularization of the tumor formation, the clinical picture of the pathology is more blurred. Patients complain of pulling pains in the lower abdomen and lower back, which can periodically intensify, weaken or disappear altogether. A pain attack may be accompanied by nausea, chills, tachycardia and fever to subfebrile values.

Diagnostic algorithm for necrosis of the myomatous node

Diagnosis of necrosis of the myomatous node is based on the data of the anamnesis and objective examination, as well as on the results of additional research methods:

• anamnestic data: the patient points to a previously diagnosed uterine myoma, makes characteristic complaints;
• objective examination data: the patient is pale, the tongue is coated, the abdomen is swollen, tense and painful during palpation in its lower sections, positive symptoms of peritoneal irritation are determined;
• Gynecological examination data: an enlarged uterus with a myomatous altered shape is palpated, during palpation the patient complains of pain in the area of ​​the pathologically altered myomatous node;
• the results of a general blood test: leukocytosis and an increase in the level of erythrocyte sedimentation rate are determined in the peripheral blood;
• ultrasound data of the pelvic organs: signs of malnutrition of the myomatous node are determined - a decrease and heterogeneity of echographic density, the appearance of cavities filled with liquid in the tissues of the node;
• laparoscopy: visualized myomatous altered uterus, torsion of the legs of the myomatous node with signs of its necrosis.

Methods of treatment for necrosis of the myomatous node

Treatment for fibroid necrosis depends on the cause of the condition. Conservative therapy is possible in case of malnutrition of the node. Infusion therapy is carried out to reduce the intoxication of the body and normalize its water and electrolyte balance. Patients are prescribed antispasmodics, anti-inflammatory drugs, as well as agents that improve microcirculation. If within 48 hours after the start of conservative therapy the patient's condition does not improve, it is necessary to perform surgery. An emergency operation is also indicated for torsion of the pedicle of the myomatous node, while the amount of intervention is determined individually in each specific case.

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