Case records and commentaries in Obstetrics and Gynaecology
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Date
2003-11Author
Endere, Frank K
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
To compare the clinical and histological diagnosis of adnexal masses excised
at Kenyatta National Hospital, Nairobi.
This was a descriptive cross-sectional study.
The mean age of the patients was 29.5 years with a range of 20-45 years, and
98.8% of the patients were literate. The mean age at menarche was 15.1 years and 71.6 %
had been sexually active by 18 years of age. There was no family history of any form of
cancer in 96.8% of the patients. The most commonly diagnosed adnexal mass by clinical
methods was ectopic pregnancy 59.3% and tubo-ovarian masses 24.7%. The main
complaint usually was lower abdominal pain alone 33.3%, or accompanied by vaginal
and/or urethral discharge 46.9%. In Intra-operative analysis, the most common diagnosis
was also found to be ectopic pregnancy 56.8% followed by benign cysts 19.8% and (non-
neoplastic) functional cysts 13.6%. The mass was noticed to be unilateral 86.4%, cystic
86.4%, freely mobile 71.6% and lacked ascites 9~8%.
The most important finding of this study was the histological diagnosis which confirmed
ectopic in pregnancy 49.4%, functional cysts comprised 25.9%. The other findings were
pelvic inflammatory disease 7.4%, serous cystadenoma 6.2%, fibroid 3.7% and serous
cystadenocarcinoma 1.2%.
Clinical diagnosis is important in detecting ectopic pregnancy confirmed by histological
diagnosis. Most of the adnexal masses were either non-neoplastic or benign. The
conclusive determination of other adnexal masses is not definitive and requires
physicians high index of suspicion whenever a complaint of lower abdominal pain is
raised. Ultrasound is a reliable pre-operative investigative tool.
Citation
Degree of Master of Medicine in Obstetrics and GynaecologyPublisher
Department of Obstetrics and Gynaecology
Description
In part fulfillment for examination of Masters Of
Medicine
In
Obstetrics and Gynaecology
Of the
University Of Nairobi