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Region 2
UNIVERSITY OF LA SALETTE, INC.
Santiago City, Isabela
A CASE STUDY
Submitted to:
MRS. JEANE C. LAURELIO, RM, RN, MSN
Instructor
Submitted by:
KHEROVINE C. TAYABAN
Student
23 March 2018
I. INTRODUCTION
Adenomyosis, also referred to as “uterine endometriosis,” is a
benign disease confined to the uterine muscle. Endometrial cells from the
lining of the endometrial cavity, migrate from that lining, most commonly
into the posterior side or back wall of the uterus. As these cells respond to
monthly hormonal changes, blood can get trapped in the myometrium
producing a hard and enlarged uterus. Adenomyosis is most frequently
seen in women in their early to middle 40s and is often associated with
hormone imbalance, usually an excessive estrogen supply. Various
published studies have shown that 12% of patients with Adenomyosis
also have been diagnosed with Endometriosis in other sites outside the
uterus, within the pelvis. As high as 62% of women who had
hysterectomy were found to have this disease on pathology reports.
At this point in research studies, the etiology or cause of
Adenomyosis is unknown. Some studies also suggest that women who
have had prior uterine surgery may be at risk for adenomyosis. A known
genetic link is also present, as with endometriosis, and it does tend to run
in family history. At this point, however, the reason for the disease
continues to be inconclusive.
The severity of the signs and symptoms associated with
Adenomyosis is often directly proportional to the degree of involvement
and penetration into the uterine muscle. The more the disease spreads,
the greater the symptoms. Many patients with Adenomyosis can be
without symptoms (asymptomatic) just like fibroids and endometriosis,
but most commonly women report the following symptoms associated
with their enlarged uterus: dysmenorrhea (painful periods),
hypermenorrhea (heavy periods), prolonged bleeding cycles, cramps,
large clots, abdominal bloating, back pain, severe and increasing
abdominal pain throughout the month, painful intercourse, and nausea
and vomiting.
The only definitive way to diagnose adenomyosis was to perform a
hysterectomy and examine the uterine tissue under a microscope.
However, imaging technology has made it possible for doctors to
recognize adenomyosis without surgery. Using MRI (magnetic resonance
imaging) to confirm a diagnosis of adenomyosis in women with abnormal
uterine bleeding or transvaginal ultrasound, doctors can see
characteristics of the disease in the uterus.
If a doctor’s suspects adenomyosis, the first step is the physical
exam. A pelvic exam may reveal enlarged and tender uterus. An
ultrasound can allow a doctor to see the uterus, its lining, and its
muscular wall. Though ultrasound cannot definitively diagnose
adenomyosis, it can help to rule out other conditions with similar
symptoms.
Another technique sometimes used to help evaluate the symptoms
associated with adenomyosis is sonohysterography. In
sonohysterography, saline solution is injected through a tiny tube into the
uterus as an ultrasound is given.
Because the symptoms are so similar, adenomyosis is often
misdiagnosed as uterine fibroids.
However, the two conditions are not the same. While fibroids are
benign tumours growing in or on the uterine wall, adenomyosis is less
defined mass of cell with in the uterine wall. An accurate diagnosis is key
in choosing the right treatment.
II. PATIENT’S PROFILE
-can be black
brown or
burgundy
depending on the
race
-Skin is smooth
with no lesions
-no muscle
atrophy
C. Review of systems
Integumentary: Paleness
RADIOLOGY RESULT
The Uterus
- Is a hollow, muscular organ that is shaped like an inverted pear The uterus,
or womb, is the part of female reproductive system in which a baby grows. It
is above the vagina, between the bladder and rectum. It is about 7 cm long
and 5 cm across at the widest point. The uterus is held in place within the
pelvis by several ligaments,
Parts:
fundus is the top of the uterus.
body is the main part of the uterus and includes the uterine
cavity.
cervix is the lower, narrow part of the uterus.
Layers:
endometrium is the inner layer that lines the uterus. It is
made up of 9enopause cells that make secretions.
myometrium is the middle and thickest layer of the uterus
wall. It is made up mostly of smooth muscle.
perimetrium is the outer serous layer of the uterus. The
serous layer secretes a lubricating fluid that helps to reduce
friction. The perimetrium is also part of the peritoneum that
covers some of the organs of the pelvic.
Function
The uterus received a fertilized egg and protects the fetus (baby) while
it grows and develop. The uterus contracts to push the baby out of the body during
birth.
Every month, except when a woman is pregnant or has reached
9enopause, the lining of the uterus grows and thickens in the preparation for
pregnancy. If the woman doesn’t get pregnant, the lining is shed through the cervix
into the vagina and out of the body. This is called menstruation. This process
continues until 9enopause.
VII. PATHOPHYSIOLOGY