Benign lesions in abdominal hysterectomies in women presenting with menorrhagia

Menorrhagia is a common and debilitating problem. It is one of the major causes leading to hysterectomy in women all over the world. Menorrhagia is most commonly associated with benign pathologies like uterine fibroids, adenomyosis and pelvic infection. Rarely it is secondary to malignant pathology like endometrial carcinoma. Hysterectomy specimens form a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in total abdominal hysterectomy specimens in patients presenting with menorrhagia. A descriptive case series study of one hundred total abdominal hysterectomies of patients presenting with menorrhagia carried out. Patients' data and detailed gross examination of specimens were recorded on a proforma. Representative sections were taken for microscopic examination and findings were recorded. The ages of the patients ranged from 30- 59 years with maximum number [73%] of cases in 40 - 49 years age group. Macroscopically fibroids were seen in 69% cases in myometrium. Microscopic examination of cervix revealed features of chronic cystic cervicitis in 100% cases. Endometrial histology showed disordered proliferation [41%] followed by hyperplasia [25%] as the commonest finding. Myometrium revealed foci of adenomyosis in 49% cases. The commonest neoplastic lesion was leiomyoma [69%]. In patients with menorrhagia the commonest neoplastic lesion was leiomyoma [69%], and commonest histopathological cervical lesion as chronic cervicitis [100%]. Endometrial hyperplasia was the most common lesion [41%] on endometrial histology. Myometrium revealed foci of adenomyosis in 49% cases

Pattern of benign morphological myometrial lesions in total abdominal hysterectomy specimens

Hysterectomy is one of the most common major surgical procedure performed all over the world. Indications for total abdominal hysterectomy include dysfunctional uterine bleeding, leiomyoma, adenomyosis, chronic pelvic pain and pelvic inflammatory disease. Other causes include endometrial hyperplasia, cervical intraepithelial neoplasia. invasive cancer and endo-metrial malignancy. Hysterectomy specimens contribute a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in myometrium of uterus in total abdominal hysterectomy specimens. A descriptive case series study of one hundred total abdominal hysterec-tomy specimens was carried out in Allama Iqbal Medical College, Lahore. One hundred total abdominal hysterectomy specimens were studied. The ages of the patients ranged from 30 - 69 years with maximum [73%] cases in 40 - 49 years age group. The commonest presenting complaint was menorrhagia [68%]. The two benign histopathological lesions in myometrium were leiomyoma and adenomyosis. Myometrium revealed leiomyoma in 6g% cases and foci of adenomyosis in 47% cases. The commonest benign histopathological lesion in myometrium was leiomyoma [69%] followed by adenomyosis [47%]

Indications and complications of intestinal stomas -a tertiary care hospital experience

An intestinal stoma is an opening of intestine on the anterior abdominal wall made surgically. The commonly performed procedures include colostomy and ileostomy. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. An observational study was carried out in Services Hospital Lahore, over a period of two years from Feb. 2007 - 09. A total of 85 patients needing intestinal stomas, ileostomy or colostomy, were included in the study. Patients under 12 years, with enterocutaneous fistula and urinary conduits were excluded from study. Indications, immediate and late complications of stomas were recorded. Reversal of stoma usually performed after 12 weeks and complications of reversal were also recorded. Majority [73%] of patients were males. There were 36 ileostomies and 49 cases of colostomy making a total of 85 patients. Main indications of Ileostomy were intestinal tuberculosis [58%], enteric perforation [31%] and penetrating injuries [5.5%]. Colostomy was mostly required in penetrating injuries [33%], blunt trauma [23%] and intestinal obstruction [28%]. In a total 0/35 stomas local complications appeared in 54 [41.77%]. General problems included anxiety, psychological and social isolation. Skin excoriation and ulceration were the most common [25%]; they were worse in ileostomy than colostomy. In laparotomy wound infection [9.4%], stoma diarrhea [7%], stoma retraction [6%] and prolapse [6%] were other notable comp-lications. A mortality rate of 1.6% was found in cases of ileostomy. Hospital admission ranged from 10 - 62 days. 62 stomas including 25 ileostomies and 37 colostomies were closed on an average of 3 months after primary operation. There were 9 cases of wound infection, three anastamotic leakages and a single mortality [1.6%] in the stoma reversal group. Common indications for intestinal stomas were abdominal trauma, intestinal tuberculosis and enteric perforation. Main complications included local skin problems, stoma diarhoea, prolapse and retraction. Early identification and treatment of tuberculosis and enteric fever can reduce stoma formation and its associated complications