This power point describes in nut shell hte definition, etiopathogenesis, clinical features, gross , histological and MRI findings in adenomyosis and its management
3. DEFINITION
Presence of endometrial islands within the uterine
wall i.e., myometrium
Usually endometrial glands are present only in
endometrial layer of uterus ,which gets sloughed
off regularly during menses
But in this condition there occurs signifying down
growth of endometrial tissues into the
myometrium
4. ETIOPATHOGENESIS
Elderly women aged above 40
Younger women are also susceptible
No clear pathogenesis .
Believed as an endometrial tissue down
growth
ASSOCIATIONS:
• Uterine fibromyomas
• Pelvic endometriosis
• Endometrial carcinomas
5. CLINICAL FEATURES
Present with menorrhagia & progressively
increasing dysmenorrhea
Pelvic discomfort, backache, dyspareunia
Painful symmetrical enlargement of uterus
suggests adenomyosis following investigations
Uterus size- resembles 3 month pregnancy
Uterus may be symmetrically or asymmetrically
enlarged
MRI is superior to USG for diagnosing
adenomyosis
7. GROSS FINDINDS (CONTD…)
Uterus appears symmetrically enlarged
resembling not more than 14 weeks size
Asymetrical enlargement of uterus may also be
seen in some cases which may confused with
myoma
Affected area shows peculiar and diffuse
involvement of myometrium
Posterior wall- dark hemorrhagic areas in b/w
normal areas
Cross section shows localized nodular
enlargement
Enlargement-due to hyperplasia of smooth
10. MANAGEMENT
HYSTERECTOMY with or without salpingo-
oopherectomy - if women aged 40 years
above and indicated
If not interested or if she is young
• NSAIDs (medical)
• GnRH(hormonal)
• Mirena IUCD
• TCRE(trans cervical resection
of endometrium)