Before coming to a case presentation…
Let us revise ….Endometrial Polyp….useful to Non Gynae doctors….
Saturday, April 10, 2010
What is Endometrial Polyp?
What is Endometrial Polyp?
An endometrial polyp or uterine polyp is a sessile mass in the inner lining of the uterus. Two Type
1. Sessile - they may have a large flat base
2. pedunculated - be attached to the uterus by an elongated pedicle.
Pedunculated polyps are more common than sessile ones. They range in size from a few millimeters to several centimeters.
If pedunculated, they can protrude through the cervix into the vagina.
Small blood vessels may be present, particularly in large polyps.
History:
History:
1.42 years female came with history of off and on spotting and heavy painful menstrual periods.
2. She had three children…
3. and history of tubal ligation 10years back.
On Examination:
1. General exam – Pallor - +
2. On per vaginal – some mass protruding out of cervix. Slight bleed on touch.
3 Per speculum exam done carefully – mass reddish in color seen…protruding through.
4. On repeat per vaginal exam it was confirmed that mass is coming through cervix….and not attached to cervix…..
Impression:
Impression:
1.? Endometrial Polyp protruding through cervix...
2. Endometrial carcinomatous mass coming out through cervix…
Investigations –
Investigations –
1. All basic investigations were done
2. Ultrasound – mass coming out form endometrial layer of uterus though cervix…diagnosis in favor of endometrial Polyp….rest pelvis –nothing specific….
Line of Treatment:
Line of Treatment:
1 Two whole blood transfusion given...
2. Posted for Abdominal Hysterectomy…
3. All necessary investigations were done...
4. Fitness for anesthesia was taken…
But Abdominal Hysterectomy Postponed…
But Abdominal Hysterectomy Postponed…
As patient started her menstrual cycle the decision of abdominal Hysterectomy was postponed…
Patient was discharged on her request…and advised to come after three days...
Patient came after two days only…
Patient came after two days only…
With history of some mass has passed per vagina while defecation….
On per speculum examination –
There was no evidence of prior endometrial polyp…
Impression – Endometrial Polyp was aborted naturally….
Treatment:
Treatment:
As per schedule decide Abdominal hysterectomy was done so as to rare possibility of endometrial carcinoma…
Total Abdominal Hysterectomy was done ….
Specimen was send for histo - pathological exam…
Report of HPE was – Endometrial hyperplasia with no evidence of malignancy…
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