CLINICAL CASE OF HEMATOMA OF VAGINAL VESTIBULE

Vulvar and vaginal hematomas are a clinically significant condition that requires a thorough assessment of etiological factors and the pathogenesis of their occurrence. This pathology is common in both obstetric and gynecological practice, with traumatic vulvar hematomas reaching up to 0.8% of all gynecological hospitalizations. The main causes are traumatic injuries in the vulva and vagina resulting from childbirth, surgery, sexual intercourse, sports, or sexual violence. The rich blood supply to the perineum and vulva contributes to the occurrence of this complication. The leading mechanisms of hematoma formation are a violation of the elasticity of the vessel wall with subsequent damage to its integrity, as well as a violation of the hemostasis system. Vaginal hematomas of small size can be asymptomatic at the beginning of formation, which can lead to underestimation of total blood loss in women and the development of anemia syndrome. In recent years, there has been an increase in cases of tubulointerstitial nephritis (TIN), which underscores the need to study its systemic manifestations. Analysis of current data shows that inflammatory and autoimmune processes underlying TIN can affect the hematological profile of patients. Using a clinical case example, this article examines the relationship between dyscirculatory, dysmetabolic TIN and the development of vaginal vestibule hematoma. The study indicates a correlation between the severity of TIN and various hemostasis disorders, which may have clinically significant consequences in the late diagnosis of this pathology. The article presents a clinical case of vaginal vestibule hematoma in a patient with diagnosed tubulointerstitial nephritis of mixed genesis, as well as a literature review on the current problem of vaginal and vulvar hematomas in gynecological practice.