scholarly journals Clinical profile of patients with pelvic adnexal masses

Author(s):  
Suksham Sharma ◽  
Ajay Wakhloo ◽  
Gagan Singh

Background: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. Aim was to study the clinical profile of women in reproductive age group presented with adnexal masses.Methods: The study comprised of 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done.A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. Out of these, majority i.e.66.67% had chronic pelvic pain and 23% had pain of less than 1-month duration which were cases of ectopic pregnancy. 41.67% cases were suspected to have endometriosis,33.33% were suspected to have ovarian cyst, followed by ectopic pregnancy in 16.67% cases and tubo-ovarian mass in 8.33% cases.Conclusions: The present study shows that if proper preoperative evaluation is done, we can select the appropriate patients for laparoscopic approach.

Author(s):  
Ajay Wakhloo ◽  
Suksham Sharma ◽  
Gagan Singh

Background: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. The aim was to study the role of laparoscopy in diagnosis and management of benign adnexal masses.Methods: The study was conducted on 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done. A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness. Laparoscopy was done to confirm preoperative diagnosis and appropriate procedure done depending on diagnosis.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. 41.67% cases were suspected to have endometriosis while on laparoscopy it was seen in 47.92%, 33.33% were suspected to have ovarian cyst which decreased to 25% on laparoscopy, ectopic pregnancy in 16.67% cases both pre-operative and on laparoscopic examination and tubo-ovarian mass in 8.33% cases pre-operatively and 2.08% on laparoscopy.Conclusions: This study has shown that if proper preoperative evaluation was done, author can select the appropriate patients for laparoscopic approach.


Author(s):  
Anuradha D. Murki ◽  
Vasundhara Kamineni ◽  
Sowmya R. Velagapudi ◽  
Ashok K. Deshpande

Background: Women with adnexal masses can present with acute symptoms such as abdominal pain, nausea and vomiting. As there is insufficient evidence on the frequency, presentation and management of adnexal masses we conducted this study to evaluate the clinical profile, surgical findings and histopathology of adnexal masses in women presenting with acute abdomen and needing surgical intervention.Methods: In this prospective observational study, history, examination, investigations and ultrasound of abdomen and pelvis were evaluated in women presenting with acute abdomen with adnexal mass and needing surgical intervention. Diagnosis was confirmed from the operative findings and histopathology. Etiology and its correlation with clinical symptoms and signs and radiological diagnosis formed the primary objective of the study.Results: Of the 79 patients enrolled in the study, the mean age was 30.82±6.69 years. Younger women were likely to have ectopic pregnancy while older women (>35 years) other tubal pathologies. Pain abdomen (n=70) and nausea (n=53), bleeding per vagina(n=33), menstrual irregularities (n=18), fever (n=10) abdominal distension (n=10) and dysuria (4) were the common symptoms. Etiology of the adnexal mass was ectopic pregnancy (57%), ovarian mass (34%), tubal mass (7.5%), tube and ovary (2.5%) in 46, 25, 6 and 2 patients respectively. 61% (n=48) of the women underwent laparoscopic management. Women with ruptured ectopic pregnancy were more likely to have abdominal distension, pallor, hypotension, cervical motion tenderness and need for blood transfusions.Conclusions: In women from reproductive age group with adnexal mass and needing surgery, ectopic pregnancies and benign ovarian tumours were the common etiologies. Urine pregnancy test and ultrasound are useful tests to differentiate ectopic from ovarian and tubal pathology.


2021 ◽  
Vol 15 (6) ◽  
pp. 1249-1252
Author(s):  
R. Mukhtar ◽  
A. U.- Rehman ◽  
A. Ilyas ◽  
M. J. Khan ◽  
R. Liaqat ◽  
...  

Aim: To determine the frequency of Bacterial vaginosis by pap smear cytology and find its association with its sociodemographic determinants. Study design: Cross sectional analytical study Place and duration of study: Department of Histopathology, Shaikh Zayed Hospital, Lahore from 1st January 2016 to 31st October 2016. Methodology: Two hundred and sixty pap smears of married women of reproductive age group with vaginal discharge who attended Gynecology OPD were included. Proper history regarding age, socioeconomic status, age of marriage, literacy level, smoking, and nutritional status was taken. Results: Disease prevalence was found to be 19.2%(50)in this sample of 260 while 9.1% had Candidiasis, 47%, 17.2% ,3.7%, 4.1% had Mild nonspecific inflammation, Moderate nonspecific inflammation, Moderate to severe nonspecific inflammation, and negative smears respectively. Bacterial vaginosis was associated with age, monthly income, illiteracy, early age at marriage, history of abortion and nutritional status with significant p-value ≤ 0.05. However no association was found between the disease and marital status, smoking and pallor. Conclusion: Low socioeconomic status, literacy, age >35, nutritional status is strongly related to occurrence of bacterial vaginosis in women of reproductive age group with vaginal discharge. Key Words: Bacterial vaginosis, Pap smear, Sociodemographic determinants


2018 ◽  
Vol 8 (1) ◽  
pp. 2-6
Author(s):  
Sangeeta Devi Gurung ◽  
Prakash Sharma

Introduction: Ectopic pregnancy (EP) is one of the major complications in first trimester pregnancy, resulting in increased maternal morbidity and mortality. It accounts for 1.3-2.4% of all pregnancies. Previously, though laparoscopy was considered as the gold standard for diagnosis of ectopic pregnancy, due to availability of high resolution ultrasound, it has become the first line investigation for the diagnosis of ectopic pregnancy.Methods: It is a prospective study conducted in Manipal Teaching Hospital, Pokhara, from January 2015 till December 2017. All the cases diagnosed with ectopic pregnancy were included in the study.  Ultrasonological and intraoperative findings were recorded. Data was analyzed using SPSS (VERSION 16).Results: Twenty six patients were diagnosed with ectopic pregnancies. The incidence was 0.35%. It was most common among the reproductive age group between 20-40 years with mean age of 30.50 years. Pelvic inflammatory disease (n=10, 38.5%) was considered as risk factor. Radiological finding of Type III ectopic pregnancy (n=21, 80.8%) was the most common type.Conclusion: Ectopic pregnancy is common among reproductive age group with previous history of pelvic inflammatory disease. Type III is the most common type.


2013 ◽  
Vol 6 ◽  
pp. CCRep.S13527
Author(s):  
Monika Rathi ◽  
Rehana Najam ◽  
Satish Kumar Budania ◽  
Seema Awasthi ◽  
Faiyaz Ahmad ◽  
...  

We present a case of a 22-year-old female who presented with acute abdomen and amenorrhea. Emergency laprotomy was done with a clinical diagnosis of ectopic pregnancy. On laprotomy, twisted fimbrial cysts were found. Thus, although fimbrial cysts are rarely twisted, they should be considered as a cause of acute abdomen in a female of reproductive age group.


Author(s):  
Nitin H Shah ◽  
Aditi Vivek Joshi ◽  
Sunita Mourya

An adnexal mass is a common entity in the reproductive age group. Ovarian masses form a majority of this condition. Tuberculosis is a disease commonly encountered in the Tropics and is endemic to India. Abdominopelvic affliction of this disease is common in women especially in the reproductive age groups. It may present with variety of non-specific clinical features and often poses an enormous diagnostic dilemma Author report one such case, presenting with a clinical impression of ovarian malignancy, however, was diagnosed to be a case of extensive pelvic tuberculosis on laparoscopy. Tissue biopsy was consistent with the finding of tuberculosis.


2020 ◽  
Vol 5 (2) ◽  
pp. 63-70
Author(s):  
Thinley Dorji ◽  
Hari Prasad Pokhrel ◽  
Tshokey Tshokey

Background: The case burden of cervical cancer has been increasing globally especially in developing countries without proper health system. Cervical cancer can be eliminated with timely vaccination and screening program as it usually takes years for pre-malignant lesions to develop into malignant lesion. Bhutan has committed to eliminate cervical cancer. Thus, it is important to understand the factors associated with abnormal Pap test findings. Methodology: A retrospective study was conducted using the Pap smear data for the year 2018. It was extracted from the records maintained in the cytology unit of Samtse General Hospital. Result: The abnormal slide rate in this study was 2.5%. The majority of women seeking Pap smear services were women in reproductive age group and housewife by occupation. There were significant differences between age groups and marital status among normal in the Pap test results. Conclusion: The slide abnormality of Pap smear in Samtse District is low. The abnormality is more common among married and older women. Therefore, additional screening efforts needs to be put into this group to detect pre-malignant lesions.


Author(s):  
Mamata Soren ◽  
Ranjita Patnaik ◽  
Bismoy Kumar Sarangi

Background: Ruptured ectopic pregnancy is a medical emergency; therefore, it is imperative to diagnose the unruptured ectopic pregnancy such that timely intervention will prevent morbidity and mortality Today with availability of monoclonal β-HCG, high resolution transvaginal scan and laparoscopy it is possible to make early diagnosis even before rupture.Methods: Prospective study of two years duration with sample of 72 cases of suspected ectopic pregnancy observed and treated out of total 20193 pregnant women admitted were included in this study.Results: The incidence was 0.36%, maximum between the age group of 26-30 years (33.3%). Risk factors were tubectomy (30.56%), D and C (6.94%), PID (5.6%), previous ectopic (1.39%), IUCD (2.78%). The typical triad of amenorrhoea, pain abdomen and bleeding was observed in 54.2% of cases. 19 patients were brought in shock (26.4%). Ultrasonography done in 56 cases.Conclusions: There is an increase in the incidence of ectopic pregnancy but a decrease in maternal mortality during the past two decades. Although the early diagnostic tools were available, we had to manage most of our patients as surgical emergencies, as they were brought late in the trial, with established diagnosis of ruptured ectopic pregnancy. Physicians should be sensitive to the fact that in the reproductive age group any women presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be entertained irrespective of the presence or absence of amenorrhoea, whether or not she has undergone sterilization. 


Author(s):  
Smriti S. Dwivedi ◽  
Malay Bajpai ◽  
Indu Bhushan ◽  
Arunima Satkirti

Background: Abnormal uterine bleeding is one of the common gynecological complaints of women of all age groups. Histopathological study of endometrial biopsy and curettage samples is an effective diagnostic modality that can be used to identify cause of AUB at its earliest. This study was done to investigate the various endometrial causes of AUB that frequently come to our hospital and their incidence in various age groups i.e. reproductive, perimenopausal and postmenopausal.Methods: This study was conducted on 108 patients who clinically presented with AUB and had their endometrial biopsy and curettage specimens sent to the histopathology department of our tertiary care hospital and teaching centre, located in Uttar Pradesh from June 2018 to May 2019. The endometrial patterns were observed, and their frequencies and percentages were computed and classified age group wise.Results: These studies included patients with age range from 19 to 77 years. The predominant age group with AUB was reproductive age group (<40 years). The most common histopathological finding in this study was normal menstrual pattern (48.15 %). The endometrial pathologies observed were hormonal imbalance and pill effect (22.22%), atrophic endometrium (10.19%), chronic endometritis (5.56%), benign endometrial polyp (4.63%), gestation products (3.70%), endometrial hyperplasia (3.70%), and endometrial carcinoma (1.85%). Conclusion: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.Conclusions: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.


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