Case Study

Patient History

• Female in 50th decade of life.
• Complains of heavy, painful menstrual periods, bleeding between cycles.
• Saw OB/GYN, pelvic complete U/S ordered.
• Surgical Hx: C-section x 2
• Pelvic complete perfomed on Phillips iU22 with 5MHz curvilinear & 9MHz vaginal transducer

Labs

• No lab work
• Pregnancy test
• Blood work

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Can you Figure out the Diagnosis?

Diagnosis

• Adenomyosis of the uterus
• Endometrium breaks through myometrium
• Best Diagnostic clue: diffuse uterine enlargment & loss of endometrial/myometrial interface.

Diagnosis

• Adenomyosis of the uterus
• Endometrium breaks through myometrium
• Best Diagnostic clue: diffuse uterine enlargment & loss of endometrial/myometrial interface.

Uterine Adenomyosis

• 79% of women with endometriosis also have adenomyosis.
• Most common s/s is menorrhagia & dysmenorrhea.
• Most painful 1 week before menses.
• Occurs in multiparous women & higher frequency in women with hx of uterine surgical procedures

Gross Anatomy

Treatment

• Hormone Control
• Hysterectomy
• Uterine artery embolization

Differential Diagnoses

Differential Diagnosis

References