She presented with vaginal bleeding of 3 months duration . It was a history of post menopausal vaginal bleeding

Emobileclinic Patient’s corner

Emobileclinic Specialist

She presented with vaginal bleeding of 3 months duration . It was a history of post menopausal vaginal bleeding. The bleeding was scanty and not associated with passage of clots. There was no associated dizziness  There was no postcoital bleeding, passage of foul smelling watery vaginal discharge or vulva itch.

No history of weight loss or anorexia.She attained menarche at 16 years. She menstruated for 5 days in a regular cycle of 30 days. Her last menstrual period was 13 years ago. Her last confinement was 27 years ago. Her sexual exposure was 6 years ago. There was no history of use of contraceptives. She had 3 live children and had spontaneous abortion at 12 weeks , four years before she had her last child. She was not a known hypertensive, diabetic or asthmatic patient. She never had hormone therapy.

She was the only wife of husband who was also a retired civil servants. She neither drank alcohol nor smoked cigarettes. She was an elderly woman but obese and healthy looking. She was not pale, anicteric, had no peripheral lymphadenopathy nor pitting pedal oedema. She was 1.68m tall and weighed 90kg.Her BMI was 31.9kg/m2.

Her breast was normal and there was no palpable masses. Her pulse rate was 82 beats per minute and blood pressure was 130/80mmHg.The heart sounds were normal. Her abdomen was full, moved with respiration, soft and non – tender. The liver and spleen were not palpably enlarged and the kidneys were not ballotable. There was no ascites.

The vagina examination showed vulva was atrophic but normal. Speculum examination revealed healthy looking vaginal wall and cervix. The vaginal was normal. The uterus was atrophic and the adnexae were free and non – tender. The cervix was firmed. It was smooth and cervical Os was closed. The pouch of Douglas was empty. The gloved finger were stained with alter blood.

Diagnosis

Post menopausal bleeding probably due to endometrial cancer.

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