HEMATOMUL VULVAR POSTTRAUMATIC

Abstract

Objectives. Hematoma of the vulva – extravasation of blood into the soft tissues of the external genitalia without lysis of the skin tissue. As a rule, nonobstetric hematomas of the vulva are associated with genital trauma and are very rarely presented in the specialized literature.

Case presentation. Until now, there is a lack of consensus and clinical recommendations in the specialized literature regarding the treatment of traumatic hematoma of the vulva, and the treatment tactic is based on the case-by-case principle. Taking into account the rarity of traumatic hematoma of the vulva, we present our own clinical case.

Patient S.I., 17 years old, came to the inpatient department of the IMSP Mother and Child Institute with vulva trauma that occurred after falling on a hard object. Upon admission, she complained of violent, expanding pain in the region of the labia majora on the right, the presence of a tumor formation in the region of the external genitalia that presented difficulties in movement. In the region of the labia majora on the right, a 10x6 cm hematoma is determined, cyanotic in color, suddenly painful on palpation with transposition to the left, which completely closes the entrance to the vagina, clitoris and urethra. Over 40 min. from admission under general anesthesia with spontaneous breathing, with a longitudinal incision along the right labia majora from its inner side, ≈ 50 ml of clotted blood was drained. For the purpose of hemostasis, three vicryl sutures were applied. She was discharged in satisfactory condition on the fourth postoperative day.

Conclusions. Traumatic hematomas of the vulva present a rather rare phenomenon and are presented sporadically in the specialized literature. In the case of large and expanding hematomas of the vulva, surgical treatment is the method of choice. The surgical intervention involves the opening and evacuation of the hematoma of the vulva, the achievement of definitive hemostasis in the remaining cavity and adequate drainage.