Decidual casts and membranous dysmenorrhoea although rare should be considered in non-pregnant women on HCG, HMG, progestogens or even combined oral contraceptive pills presenting with severe cramping abdominal pain and bleeding with passage of tissue. The appearance of the normal lining of the uterus, by the effect of progesterone, becomes decidualized. SUMMARY TABLE Condition Characteristics Decidual cast Lining of the endometrium that is sloughed off in one piece, forming a cast of the uterine cavity; may be associated with ectopic pregnancy positive pregnancy test or exogenous progesterone Ectopic pregnancy Positive pregnancy test; may be associated with decidual cast Hydatidiform mole Positive pregnancy test; benign mass of abnormal cysts Products of conception Positive pregnancy test; consists of decidua and developing embryo, although the embryo may not be visible Vaginal foreign body Negative pregnancy test; nonfleshy with a malodorous discharge. The pelvic discomfort completely resolved after the mass was passed. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors’ Guide at http: Based on the patient’s history and physical examination findings, which one of the following is the most likely diagnosis?
At ultrasonography an ectopic pregnancy with a decidual cast is often mistaken for an intrauterine pregnancy 2. R Pingili, W Jackson. They are most common in the fallopian tube but can be located in the ovary or the abdominal cavity. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Decidual casts associated with depomedroxyprogesterone acetate treatment in adolescents. Earn up to 6 CME credits per issue.
International Journal of Obstetrics and Gynaecology, 36, Citation R Pingili, W Jackson.
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We report an interesting case of passage of decidual cast tissue. Eectopic is uncommon to see a decidual cast of the mentioned size, shape and thickness with the use of standard dose combined oral contraceptive pill. Foreign bodies are not fleshy in nature xast are associated with a mal-odorous discharge. Email Alerts Don’t miss a single issue. Anemia in Older Adults. To see the full article, log in or purchase access. A healthy Menstrual Cycle. Vaginal foreign bodies are common, particularly forgotten tampons.
They are most common in the fallopian tube but can be located in the ovary or the abdominal cavity.
Partially necrotic endometrium decidusl marked decidua like change of the stroma but rather inactive dilated glands. This content is owned by the AAFP.
Discussion The lining of the pregnant uterus, other than the area taken up by the placenta, is called the decidua. The decidua is the thick lining of the uterus that forms as deidual result of progesterone. Negative pregnancy test; nonfleshy with a malodorous discharge. A urine pregnancy test result was negative. Sign up for the free AFP email table of contents. Decidual casts have a well-known association with ectopic pregnancies.
Fleshy Mass Passed Vaginally by a Young Woman
While the physician was obtaining the history, the patient developed intense pelvic pain and excused herself to the bathroom where she passed a bloody, fleshy mass vaginally Figure 1. Her uterus was normal size with no adnexal mass or tenderness. The answer is A: References show all references 1. Choose a single article, issue, or full-access subscription. cawt
Read the full article. Question Casst on the patient’s history and physical examination findings, which one of the following is the most likely diagnosis? See My Options close Already a member or subscriber?
Decidual cast | Radiology Reference Article |
Membranous dysmenorrhoea is rare and causes intense cramping pain as a result of the passage of intact endometrial cast through an undilated cervix. The histopathological examination confirmed the diagnosis. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial ectoplc.
Continue reading from October 1, Previous: Already a member or subscriber? The double sac sign in early intrauterine pregnancy: Oct 1, Issue. The pelvic discomfort completely resolved after the mass was passed. A pregnancy test would be positive, with an empty uterine cavity on ultrasonography after passage of the products.
Positive pregnancy test; benign mass of abnormal cysts. Reprints are not available from the author. Close Enter the site.
R Pingili, W Jackson. Ectopic pregnancies are pregnancies that implant outside of the uterine cavity. At ultrasonography an ectopic pregnancy with a decidual cast is often mistaken for an intrauterine pregnancy 2.
The lining of the pregnant uterus, other than the area taken up by the placenta, is called the decidua. Anemia in Older Adults Next: She had vaginal spotting over the previous week but no urinary symptoms or other vaginal discharge.
It is uncommon to see a decidual cast with the use of standard dose combined oral contraceptive pill. She had negative pregnancy test. Address correspondence to Louis Strauss, MD, at louis. Get immediate access, anytime, anywhere. Cast of uterine cavity 5x6x1 cm. She took those pills for 3 months. After 15 days of her last pill she started to have painful vaginal bleeding associated with severe cramping lower abdominal pain for which she came to the hospital and she passed the decidual cast tissue, and her symptoms settled after the passage of the ectipic.
She was scanned later which revealed normal uterus and ovaries.