OSPITAL NG MAYNILA MEDICAL CENTER DEPARTMENT OF OBSTETRICS AND GYNECOLOG

NAME: !, "# $

Cabsag, Marieta

DATE: November (OSPITAL Co-ta,t -/mber:

AGE%SE&: !# 'o%F N)MBER: *"+#*! ADDRESS: Base,o, Ma-i.a #01021"2#$!

ADMITTING DIAGNOSIS:

G+P131#"14 Pe.voab5omi-a. mass 6robab.' Ovaria- I- Origi6robab.' be-ig-7 S%P Primar' Cesare- se,tio- G+ 8or 6.a,e-ta 6revia 3Baro-ga6rovi-,ia. 9os6ita., 00$4

P9'si,ia-s: Drs7 Santos /Dimson /Agarin, Amado /Pratama

CASE PROTOCOL

This is a case of a 50 year old female who came in for Abdominal enlargement.

(PI 3 months PTC !" noted mass on #mbilical area, egg si$e, mo%abale, nontender &o abdominal 'ain &o %aginal bleeding &o changes in bladder habit &o dys#ria &o weight loss &o cons#lt done

OSPITAL NG MAYNILA MEDICAL CENTER DEPARTMENT OF OBSTETRICS AND GYNECOLOG

( month PTC

!" Persistent of sym'toms !" e'igastric 'ain !" cons#lt at )* ommc and diagnosed gastritis Patient was ad%ised for +A, -T. and PAP Smear

)ew ho#rs PTC !" Patient was referred for +A, -T. and PAP Smear res#lts.

C/&S-0T

PM( 1" 2y'ertension 1" D*, 1" ,A 1" 3oiter or C4D was noted. &o allergy to food nor dr#gs.

Fami.' (istor' 1" 2y'ertension 1" D* 1" ,A 1" PT,

P%S (: 1" smo5er 1" alcoholic be%erage drin5er

OSPITAL NG MAYNILA MEDICAL CENTER DEPARTMENT OF OBSTETRICS AND GYNECOLOG

Me-str/a. (istor' Age of menarche at (( years old with reg#lar inter%als lasting for 3 days and #ses 613 'ads/day 1" dysmenorrhoea. 0*P 7 &o%ember (8 60(3 P*P 7 &o%ember 30 60(3

Se:/a. (istor' Age of (st coit#s at 63 years old with ( se9#al 'artner. &o #se of /CP. &o STD, 1" dys'are#nia 1" PC,.

OB (istor'
G+P1 31#"14

3( 36 33 38 35 3<

(:; < (:; = (:; ; (:; : (:: 0 (:: 3

Abortion Abortion * ) ) ) )T )T )T )T &SD &SD &SD CS 2ome 2ome 2ome ,arongan 'ro%incial hos' 1")*C 1")*C 1")*C 1")*C

P9'si,a. E:am Conscio#s, coherent, not in in cardiores'iratory distress. 4ital Signs7 ,P1((0/=0 mm2g 2>1=< >>168 Tem'.13<,8 ,*?7 6;.5 2@@&T &AD, no C0AD C/0 so#nds C4S m#rm#rs 7 Anicteric sclerae, 'ale 'al'ebral conA#ncti%ae, no 7 Symmetrical chest e9'ansion, no retractions, clear breath 7 Adynamic 'recordi#m, normal rate reg#lar rhythm, no

OSPITAL NG MAYNILA MEDICAL CENTER DEPARTMENT OF OBSTETRICS AND GYNECOLOG

Abdomen

7 3lob#lar, soft, nontender with 'el%oabdominal meas#ring 60 9 63 cm, cystic, mo%able

PEL;IC: ?ns'ection 7 3rossly normal loo5ing e9ternal genitalia S'ec#l#m e9amination 7 4aginal wall smooth, Cer%i9 smooth and clean loo5ing, no nod#lation, no erosion. ?@7 Cer%i9 firm closed, #ter#s and adne9a cannot be assessed d#e to h#ge 'el%oabdominal mass e9tendingfrom sym'hysis '#bis #' to 8 finger below 9y'hoid 'rocess meas#ring (6 9 (; cm, cystic, mo%able, nontender. @BT>@*?T?@S7 3rossly normal, f#ll eC#al '#lses, no edema ASSESSMENT G+P131#"14 Pe.voab5omi-a. mass 6robab.' Ovaria- I- Origi6robab.' be-ig-7 S%P Primar' Cesare- se,tio- G+ 8or 6.a,e-ta 6revia 3Baro-ga6rovi-,ia. 9os6ita., 00$4

PLAN )or @9'loratory 0a'arotomy, Total Abdominal 2ysterectomy with ,ilateral Sal'ingo1oo'horectomy

<9o.e Ab5ome- ).traso/-5 3)NITED, November 1, "# $" T9e /ter/s is a-teverte5 a-5 meas/res !7*:!7!:17+,m7 It e:9ibits a 9omoge-o/s e,9o6atter-7 No 8o,a. .esio-s see-7 T9e e-5ometri/m is /-t9i,=e-e5 a-5 meas/res 07*mm7 T9e .e8t ovar' is /-remar=ab.e a-5 meas/res $7#:"7": 7+,m7 A "7 : 7+: 7",m a-e,9oi, 8o,/s >it9 6osterior a,o/sti, e-9a-,eme-t is see- >it9i- t9e .e8t ovar' 6robab.' a 69'sio.ogi, ,'st7 T9e rig9t ovar' is -ot vis/a.i?e57 No a5-e:a. masses or 8./i5 i- t9e ,/.@5e@sa,7 Over.'i-g bo>e. gas obs,/res t9e rest o8 t9e ab5ome-7 Large ,om6.e: ab5omi-a. mass as 5es,ribe5, 6robab.' aovaria- -e> gro>t9, ,.i-i,a.% tra-svagi-a. /.traso/-5 ,orre.atio- is s/ggeste5 Mi.5 8att' .iver ,9a-ges )-remar=ab.e /.traso/-5 o8 t9e ga..b.a55er, vis/a.i?e5 6a-,reas, s6.ee-, =i5-e's, aorta a-5 6araaorti, areas, 8

IMPRESIO NS

OSPITAL NG MAYNILA MEDICAL CENTER DEPARTMENT OF OBSTETRICS AND GYNECOLOG

/ri-ar' b.a55er, /ter/s a-5 .e8t ovar' No-@vis/a.i?e5 rig9t ovar'7

Tra-svagi-a. ).traso/-5 3)NITED, November )ter/s Cervi: E-5ometr i/m A5-e:a.

0, "# $A Da' + o8 me-ses4

The #ter#s is ante%erted with smooth conto#r and homogeno#s echo'attern meas#ring <.0 9 8.: 9 8.8 cm 3.= 9 3.6 9 6.= cm The endometri#m is hy'erechoic and meas#res 0.3; cm with intact s#bendometrial halo The right o%ary is not %is#ali$ed. /n abdominal scan, there is a 'redominantly #niloc#lar, anechoic cystic str#ct#res occ#'ying the the 'el%oabdominal area more on the right and e9tending #' to the infrahe'atic region. ?t meas#res (5.: 9 (=.( 9 :.= cm. There is a m#ltise'tated loc#le meas#ring 8.: 9 5.( 9 3.: cm. The ca's#le mes#res 0.6 cm while the se't#m meas#res 0.3 cm. The left o%ary meas#res 6.: 9 6.0 9 (.; cm &o free fl#id in the c#l de sac ABDOMINOPEL;IC MASS CONSIDER O;ARIAN IN ORIGIN PROBABLY BENIGN BY SASSONEB+, LERNERB NORMAL ANTE;ERTED )TER)S <IT( T(IN ENDOMETRI)M NORMAL LEFT O;ARY

Ot9ers IMPRESIO NS

T/mor mar=er CA (65 CA (:1 : 6(.06 -/m0 85.60 -/m0