A 42 years old unmarried female had presented with complaints of feeling extremely cold and weak along with shortness of breat upon exertion. The patient also had a history of palpitations for a week. She provided
She provided history of a lump in her lower abdomen which had increased in size over a month. She had regular menstrual cycles of 28 days with heavy flow, passing clots with flooding of blood on days 2 and 3. This had been experienced by her for the past 7 years and she had never underwent any treatment for the heavy cycles. She had continuous bleeding for one month and reported to Dr. Sejal Devendra Surti – Specialist in Obstetrics and Gynecology
Upon examination, an extremely distended abdomen was observed with a mass which could be felt up to the epigastrium that extended to the lumbar region; the mass was non-tender and made it impossible to palpate beneath it. The woman’s Haemoglobin levels were down to 5.3gm/d1. An MRI Pelvis was suggested which showed a grossly enlarged uterus measuring 26x24x14cm with multiple fibroids.
Diagnosis: Large fibroid causing menorrhagia and microcytic anaemia.
Treatment: The anaemia was treated by transfusing 3 units of blood before surgery in addition to iron infusions.
A midline incision on the abdomen showed a big mass extending from the diaphragm to the pelvic floor. After assessment, extension of incision delivery of mass was conducted. Multiple fibroids were seen occupying the entire uterus with very big tortuous blood vessels between them. Total hysterectomy with bilateral
Multiple fibroids were seen occupying the entire uterus with very big tortuous blood vessels between them. Total hysterectomy with bilateral salpingo-oophorectomy was performed as discussed with the patient beforehand. While operating, extreme care was taken to avoid injury to a lot of pelvic structures like intestines, bladder, and ureters due to the altered anatomy owing to the effect of the giant fibroids.
The specimen weighed a massive 6.5kg and has been sent for histopathology evaluation.
Dr. Sejal Devendra Surti
MBBS, MD
Specialist in Obstetrics and Gynecology
Aster Hospital, Mankhool
