scholarly journals Total abdominal hysterectomy in a Tertiary Hospital in Kumasi: Indication, Histopathological Findings and Clinicopathological Correlation

2018 ◽  
Vol 7 (1) ◽  
pp. 22-28
Author(s):  
N. A. Titiloye ◽  
B. M. Duduyemi ◽  
E. A. Asiamah ◽  
I. Okai ◽  
P. P. S. Ossei ◽  
...  
Keyword(s):  
Histological Finding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Tertiary Hospital ◽  
Histological Diagnosis ◽  
Clinical Indication ◽  
Biomedical Sciences ◽  
Wide Range ◽  
Histological Confirmation ◽  
Age Range

Hysterectomy is the commonest gynaecological surgery worldwide. Hysterectomy is commonly performed in our centre with request for post-surgical histological confirmation of pathologies. The aim of this study was to review all the hysterectomy specimens sent to our department between 2008 and 2016 and analyse the histological diagnosis in them and clinically correlate with the indications for the surgery. We reviewed retrospectively request forms, histological reports and slides generated for all cases of hysterectomies sent to our department for histological assessment between 2008 and 2016 totalling 1086. All the data obtained were analysed using SPSS 21. A total number of 1086 cases of hysterectomies with or without salpingooophorectomy were received in our department. The age range was 15 to 85 years with age group 40 to 49 years constituting 57.7% of cases. The commonest indication for surgery was uterine mass which constituted 722 cases (66.42%) and an obvious uterine mass was found at grossing in 737 cases (66.48%) while histology revealed uterine leiomyoma in 861 cases (79.28%) constituting the largest proportion of histological diagnosis. Other indications for surgery include dysfunctional uterine bleeding, suspected ovarian and cervical malignancy and peri-partum haemorrhage. Histological diagnoses confirmed wide range of lesions within the endometrium, cervix, fallopian tubes and ovaries. There was correlation between clinical indication and histological diagnosis up to 90.2% of all cases. Our data confirmed hysterectomy specimens with or without salpingo-oophorectomy as a common histological specimen in our laboratory, with peak age of patients in the fifth decade. Leiomyoma was the commonest histological finding and other wide ranges of pathologies were seen with strong positive (r = 0.98) correlation between pre-operative indication and the final diagnosis.Journal of Medical and Biomedical Sciences (2018) 7(1), 22 - 28

scholarly journals Degenerated fibroid: a diagnostic dilemma

2020 ◽  
Vol 9 (4) ◽  
pp. 1766
Author(s):  
Nayanika Gaur ◽  
Manish Jha
Keyword(s):  
Histopathological Examination ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cystic Degeneration ◽  
Ovarian Malignancy ◽  
Imaging Studies ◽  
Diagnostic Dilemma ◽  
Fibroid Uterus ◽  
Wide Range

Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.

scholarly journals Histopathological analysis of hysterectomy specimens in a tertiary care centre: study of 160 cases

2019 ◽  
Vol 6 (8) ◽  
pp. 2856
Author(s):  
Roopali Jandial ◽  
Mehnaz Choudhary ◽  
Kuldeep Singh
Keyword(s):  
Clinical Diagnosis ◽  
Tertiary Care ◽  
Life Time ◽  
Total Abdominal Hysterectomy ◽  
Clinical Indication ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Cervical Lesions ◽  
Tertiary Care Centre ◽  
Wide Range

Background: Hysterectomy is the most commonly performed gynaecological surgery as the female reproductive system has been affected by various non-neoplastic and neoplastic conditions during the life time of a woman.Methods: This retrospective study was conducted on 160 hysterectomy specimens reported to Department of Pathology. They were compared in terms of age of the patients and pathology of hysterectomy specimens. The histopathological findings of hysterectomy specimens was noted and these findings were then correlated with clinical diagnosis. The aim of the study was to evaluate the wide range of pathological lesions, commonest pathology involved and correlation of the preoperative clinical diagnosis with the histopathological diagnosis in the hysterectomy specimens.Results: The most common type of hysterectomy was total abdominal hysterectomy with bilateral salpingo-ophorectomy with 102 cases (63.7%). Peak incidence at 5th decade of life in 92 cases (57.5%) was noted. The most common clinical indication was fibroid uterus in 81 cases (50.6%). Proliferative phase of endometrium was the commonest finding in 87 cases (54.3%). In case of myometrium, 95 leiomyomas were noted. On histomorphological study of cervical lesions, chronic cervicitis was commonest finding in 75 (46.8%) cases.Conclusions: Few double pathologies can be missed clinically so clinico-pathological correlation in all cases of hysterectomy has been proved to be important to improve the clinical outcome and post-operative management.

scholarly journals A Preliminary Study to Propose an Algorithm for Management of Cesarean Scar Pregnancy

2020 ◽  
Vol 9 (4) ◽  
pp. 258-262
Author(s):  
Azam Tarafdari ◽  
Sedigheh Borna ◽  
Sheida Janatrostami ◽  
Sedighe Hantoushzadeh ◽  
Fatemeh Keikha
Keyword(s):  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cesarean Scar Pregnancy ◽  
Fetal Reduction ◽  
Cesarean Scar ◽  
Beta Human Chorionic Gonadotropin ◽  
Median Period ◽  
Β Hcg ◽  
Age Range

Objectives: There is no consensus on the management of cesarean scar pregnancy (CSP). In this regard, this study proposed an algorithm for CSP management with consecutive outcomes. Materials and Methods: In this randomized clinical trial study, the data of 44 patients with CSP were collected, and the diagnosis was confirmed by transvaginal ultrasonography (TVS). Unstable patients underwent uterine artery embolization (UAE), and the fetal reduction was done for patients with the fetal heart rate (FHR). In addition, patients received systemic methotrexate (MTX) injections according to their beta-human chorionic gonadotropin (β-hCG) levels and then were followed on a predetermined schedule by β-hCG levels and TVS. Finally, prophylactic UAE was considered for patients with ongoing bleeding, placental hypervascularity, and the prospect of limited access to care. Results: Patients were within the age range of 33.9±4.9 years and the gestational age of 7.37±1.57 weeks. Twenty-two patients (50%) had vaginal bleeding, 3 of whom were unstable and underwent UAE. Five patients underwent a total abdominal hysterectomy, and fourteen patients with FHR underwent a fetal reduction. Based on β-hCG levels and changes, and placental vascularity, 4 patients received no treatment. In general, 11, 2, and 9 patients received single, double, and multiple MTX injections. A total of 10 patients underwent both multi-doses of MTX and prophylactic UAE. The median period to reach undetectable β-hCG levels was 7.3 weeks and the median interval to start menstruation was 2.8 weeks. In addition, the pregnancy remnant was resolved 3.6 months after the treatment. On the follow-up, no curettage or hysterectomy was needed and seven patients became pregnant (15.9%), 2 of whom presented recurrent CSP (28.6%). Conclusions: The proposed stepwise algorithm could be employed for CSP management with accountable outcomes, low hysterectomy rates, and fertility preservation.

scholarly journals HISTOPATHOLOGICAL STUDY OF UTERINE LESIONS IN HYSTERECTOMY SPECIMENS IN A TERTIARY CARE HOSPITAL.

2020 ◽  
pp. 1-2
Author(s):  
Reddythota Sujeeva Swapna ◽  
V Siva Sankar Naik ◽  
C Bhavani ◽  
M Neeraja
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Female Genital Tract ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
The Body ◽  
Histopathological Study ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Wide Range

Background: The Female Genital Tract is a hormone-responsive system to a degree unmatched by any other system in the body. The gross configuration of the uterus changes dramatically throughout life. It is a kind of 'Puppet on a string", thus manipulated throughout life by altering levels of ovarian hormones. Objective of the study: The present study is aimed at detailed histopathological evaluation of uterine lesions of hysterectomy specimens. Methodology: A total of 448 cases of hysterectomy specimens were received in the department of pathology GGH Ananthapur, for two years, were reviewed. The specimens were processed, and the histopathological diagnosis was studied. Result: Peak age group of hysterectomy was 40-49 years with 186 (41.51%) cases. The youngest patient was 21 years old, and the oldest was 75 years old. The most frequent type of hysterectomy done was total abdominal hysterectomy in 293 (65.4%) cases. Conclusion: Hysterectomy is the most common surgery performed in gynecological practice. A wide range of lesions were noted when hysterectomy specimens are subjected to histopathological examination.

scholarly journals Evaluation of Blood Transfusion Practices in Obstetrics and Gynecology in a Tertiary Hospital in Bangladesh

2016 ◽  
Vol 34 (1) ◽  
pp. 9-14
Author(s):  
Ferdousi Chowdhury ◽  
Sayeba Akhter ◽  
Aminul Islam ◽  
Junnu Rayen ◽  
Nayeema Begum ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Tertiary Hospital ◽  
Obstetrics And Gynecology ◽  
Junior Doctors ◽  
Transfusion Rate ◽  
Blood Products ◽  
College Hospital ◽  
Excessive Bleeding

Background: Blood transfusion is a life saving intervention in some obstetric and gynecological cases but is associated with risk of transfusion reaction and transmission of infection . Appropriate use of blood and blood products is of utmost importance for the safety of the patients. During the evaluation of an ongoing study on PPH,it appears that rate of blood transfusion is unexpectedly high in this centre, which raised the inquisitiveness in evaluating the rate and rationality of blood transfusion in present practice.Objective : To determine the incidence of blood transfusion in admitted and operated cases and is also to evaluate the indication of transfusion among the study patients. Subject and Method: It was an observational descriptive study, conducted from 1st April 2012 to 30th June 2012 in department of obstetrics and gynecology of Ad-din Women Medical College Hospital , Dhaka . Total 256 cases were included for the study, who received blood and /or blood products during the study period.Results: Transfusion rate in total admitted patients was 9.23% . Most common indication for blood transfusion in obstetric patients was mild preoperative anaemia with or without excessive bleeding during cesarean section (63.92%) and second common cause was antenatal anaemia (24.05%). In gynecological cases abortion (45.91%) was the commonest indication for blood transfusion and next common conditions were total abdominal hysterectomy (20.40%),vaginal hysterectomy (7.14%), ectopic pregnancy and post coital tear (6.12%) and( 6.12%).Conclusion: In this study it was observed that, blood transfusion was not appropriate in all cases, specially in cases where single unit blood was transfused . So creation of awareness among the junior doctors, obstetricians, nurses – midwives is essential by developing regular education and training programme.J Bangladesh Coll Phys Surg 2016; 34(1): 9-14

scholarly journals A 17-year study of paediatric cytopathology in a tertiary hospital in Sokoto, Nigeria

2019 ◽  
pp. 258-267
Author(s):  
K Abdullahi ◽  
B Jibrin
Keyword(s):  
Clinical Judgment ◽  
Needle Aspiration ◽  
Tertiary Hospital ◽  
Clinical Indication ◽  
Resource Poor Setting ◽  
Preliminary Evaluation ◽  
Female Ratio ◽  
Frequency Of Use ◽  
Needle Aspiration Cytology ◽  
Age Range

Background: Cytopathology offers a rapid diagnosis of suspicious lesions, aiding prompt clinical judgment. The extent of the cytopathologic practice is variable, thus justifying the need to assess the frequency of its use in health care centres in resource-challenged settings. Objectives: To assess the frequency of use of cytopathology services, the demographic features of the patients and the various diagnostic outcomes. Methods: The study was a retrospective analysis of 17 years’ records; including parameters like the basic demographics and cytomorphologic diagnoses in paediatric practice. Data was sought from histopathology department registers and cytopathologic request forms for patients in the age range of 0-15 years. Results: The total number of the paediatric cytologic specimen was 930 constituting 12.3% of all cytologic specimens received in the study period. The mean age was 8.0 years with a range of 1 day to 15 years. There were 537/930 (57.7%) males and 378/930 (40.6%) females with a male-to-female ratio of 1.4:1. The specimens were obtained by fine-needle aspiration cytology in 596/930 (64.1%) cases or smears of exfoliative specimens in 334/930 (35.9%) cases. Most of the samples were obtained from children in 6 - 10 years age group. The commonest clinical indication for the cytology was “suspected malignancy” comprising 370/930 (39.8%) cases. The most frequent cytopathological diagnosis was “positive for malignancy”, accounting for 232/930 (24.9%) cases. Conclusion: Cytopathology practice in a resource-poor setting remains a useful tool in the preliminary evaluation of lesions.

scholarly journals Subinvolution of the placental site as the cause of hysterectomy in young woman

2021 ◽  
Vol 14 (2) ◽  
pp. e238945
Author(s):  
Olga Triantafyllidou ◽  
Stavroula Kastora ◽  
Irini Messini ◽  
Dimitrios Kalampokis
Keyword(s):  
Young Woman ◽  
Young Women ◽  
Postpartum Haemorrhage ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Retained Products Of Conception ◽  
Products Of Conception ◽  
Fertility Sparing ◽  
Placental Site ◽  
Retained Products

Subinvolution of placental sites (SPSs) is a rare but severe cause of secondary postpartum haemorrhage (PPH). SPS is characterised by the abnormal persistence of large, dilated, superficially modified spiral arteries in the absence of retained products of conception. It is an important cause of morbidity and mortality of young women. In this study, we present a case of secondary PPH in a young woman after uncomplicated caesarean delivery who was deemed clinically unstable, and finally, underwent emergent total abdominal hysterectomy. We reviewed the literature with an emphasis on the pathophysiology of this situation. Treatment of patients with SPS includes conservative medical therapy, hysterectomy and fertility-sparing percutaneous embolotherapy.

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