2. Particulars of the Patient
Name: Mrs. Rahela Begum
Age: 55 years
Religion: Islam
Occupation: Shopkeeper
Marital Status: Married for 40 years
Blood Group: B (+ve)
Husband’s Name: Mr. Abdur Jabbar
Husband’s occupation: Shopkeeper
Address: Taraganj, Rangpur
3. Continuation
Hospital Record:
Bed No. 11
Ward No. 12
Unit No. 01
Department of Obs. & Gynecology
Rangpur Medical College, Rangpur
Date of Admission: 27/12/2015
Date of Examination: 30/12/2015
4. Chief Complaints
Post coital bleeding for 1 year
Foul smelling per vaginal discharge for 6
months
Per vaginal bleeding on straining for 4
months
Back pain for 4 months
5. History of Present Illness
According to the statement of the patient she was
reasonably well 1 year back then she suddenly
developed post coital bleeding that was excessive
in amount and bright red in color. She also gives
history of foul smelling dirty brown colored per
vaginal discharge for 6 months that was thick in
consistency but not associated with itching. She
further mentioned about per-vaginal bleeding on
straining occasionally for 4 months. She has
continuous low back pain for 4 months which was
insidious in onset with no radiation and no
aggravating and reliving factor. On query she also
complains of anorexia and weight loss. Her bladder
habit is normal but she is constipated.
6. History of Past Illness
She has no significant past medical,
past surgical and past gynecological
history.
17. Systemic Examination
Abdominal Examination:
Shape of the Abdomen: Scaphoid
Colour of the skin: Normal
Liver: Not Enlarged
Spleen: Not Palpable
Superficial & Deep Palpation: No mass found
Vaginal Examination
(i)Inspection: Foul smelling dirty brown thick
discharge found. She was using vulval pad.
18. Systemic Examination Cont.
Per Speculum Examination: A cauliflower like
growth which bleeds on touch, replaces the
cervix.
Bimanual Examination: The cervix is fixed, hard
in consistency, friable & bleeds on touch. The
fornices are obliterated, whole vaginal wall is
involved and the growth extends to the
parametrium & adjacent organ.
Digital Rectal Examination (DRE): Post. fornix
adhered with the Ant. wall of rectum.
19. Provisional Diagnosis
My provisional diagnosis is it is a case of
Carcinoma of Cervix Stage Iva (In operable
Stage)
22. Salient Features
Mrs. Rahela Begum, 55 years old, para 4(-1)+0, ALC-
15years, post menopausal Muslim patient, wife of Mr. Abdul
Jabbar a shopkeeper hailing from Taraganj, Rangpur. Got
admitted into Rangpur Medical Hospital 27Dec2015 with the
complaints of postcoital bleeding for 1 year, foul smelling
dirty brown colour vaginal discharge for 6 months, P/V
bleeding on straining for 4 months, back pain for 4 months.
She married at 12 years of age. Her husband has three wives
and she is 2nd of them, and other two had died during child
birth. She had BLTL 10 years back. On examination she is
severely anaemic, cachectic, weight loss. Abdominal
examination reveal nothing significant, On P/S examination A
cauliflower like growth that replaces the cervix. & on
Bimanual examination whole vagina is involved, cervix is
fixed, hard, friable, bleeds on touch, fornices are obliterated.
On DRE ant. Rectal wall is adhered with post. fornix.
23. Treatment
Before Staging: Blood transfusion to
correct anemia & antibiotic to prevent
secondary infection.
Specific Treatment For this patient:
1. Chemoradiation
2. Ultraradical Surgery & Palliation