Images in… BMJ Case Reports: first published as 10.1136/bcr-2016-217161 on 23 August 2016. Downloaded from Cervical stenosis causing haematocervix and haematometra in a postmenopausal woman Nicola English, Ellen Harker, Mathias Epee-Bekima King Edward Memorial DESCRIPTION Prior to the procedure she presented with wor- Hospital for Women Perth, A 73-year-old woman was referred to our gynaecol- sening suprapubic pain. She was febrile and tender Subiaco, Western Australia, Australia ogy clinic with a 2-week history of pelvic and suprapubically. An emergency EUA was performed vaginal pain. The pelvic ultrasound and CT scan with a presumptive diagnosis of an infected Correspondence to suggested a 10 cm haematometra and a 4 cm haematometra. Dr Nicola English, nicola. cervical cyst (figures 1–4). At time of surgery the initial cervical mass was
[email protected] She had no history of postmenopausal bleeding found to be a large haematocervix with stenosis of Accepted 6 August 2016 and her most recent pap smear was normal. the external os. The cervix was incised and dilated The patient had been using tamoxifen for the which drained 800 mL of old blood from the previous 10 years for primary breast cancer. cervix and uterus. The underlying endometrium Examination revealed a large, mobile uterus and appeared normal on hysteroscopy. Histology was what appeared to be a cervical mass obscuring the also normal. cervical os. She was discharged home well on day 4 She was booked for an examination under anaes- postoperatively. thesia and hysteroscopy. http://casereports.bmj.com/ Figure 1 Pelvic ultrasound scan featuring a large haematometra.