Monday, August 3, 2009

Falling Out of Place

A 70 year old G4P4 (all vaginal deliveries) presents with a sensation of pelvic heaviness. "It's like I'm sitting on an egg," she says. She also has some low back pain. Her symptoms worsen during the day and with long periods of physical exertion; lying down makes them better. She's noticed some urinary stress incontinence as well. She has obesity, COPD, and chronic cough. Review of systems is positive for constipation.

Challenge: What's your most likely diagnosis?

Image is in the public domain.
at

3 comments:

  1. AnonymousAugust 4, 2009 at 8:56 AM

    uterine prolapse

    ReplyDelete
  2. AlexAugust 4, 2009 at 9:24 PM

    rectocele?

    ReplyDelete
  3. CraigAugust 5, 2009 at 6:23 PM

    yep
    -
    Falling Out of Place

    This is pelvic organ prolapse, hernia of the uterus (uterine prolapse), vaginal apex (vaginal vault prolapse), bladder (cystocele, cystourethrocele), or rectum (rectocele, enterocele) from its normal location, graded from 0-4.

    Sources: UpToDate; Wikipedia.

    ReplyDelete

Comments on this blog are moderated so they will not show up until after the solution to the case is posted.

Note: Only a member of this blog may post a comment.