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Pain in abdomen : Need of widening the spectrum

Author: 
Nagraj, V., Manchanda, R., Mahawar, P. and Bhargava, N.
Subject Area: 
Health Sciences
Abstract: 

Adenomyoma is circumscribed nodular aggregate of benign endometrial glands surrounding endometrial stroma with leiomyomatous smooth muscle. The presenting complaint being abdominal pain, dysmenorrhea and abnormal uterine bleeding. The aim of reporting this case is to highlight adenomyoma as the cause of chronic /acute pelvic pain and to distinguish it from it’s sinister causes and to establish laparoscopic diagnosis and resection as the earliest method of intervention. Here we report a case of lady presenting with severe pain in abdomen for 2.5 yrs. Her laboratory investigations were normal. Ultrasound showed a fibroid of 2*2 cm on left side of uterus. Patient had undergone upper and lower GI endoscopy which was normal. Laparoscopy revealed a myoma of 3*3 cm and an adenomyoma of 1*2cm on the fundus near the left cornua which were resected. Post surgery her symptoms abated dramatically and 5 months later the patient is still pain free for the first time in almost 3 yrs. On conclusion though adenomyoma is rare, we should be vigilant for its diagnosis and treatment in case of severe pain in abdomen, and the use of laparoscopy in the diagnosis and treatment of adenomyoma can help many a lady suffering from pain.

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