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15 November 2023 : Case report  Mexico

[In Press] Unusual Manifestation of Membranous Dysmenorrhea: Case Report

Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Clinical situation which can not be reproduced for ethical reasons

Brianda Lizett Luna-López1DEF, Jose Pavel Zatarain-Mendívil1DE, Jennifer Peña-Borrego1DE, Jesús Cortez-Hernández2DE, César Favela-Heredia1CEF, Joel Murillo-Llanes ORCID logo3CEF, Adrian Canizalez-Roman ORCID logo45AE, Nidia Leon-Sicairos64CEF, Mario F. Barajas-Olivas3ABE, Fred Morgan-Ortíz7BCEF, Dalia Magaña-Ordorica8ABEF, Francisco Castro-Apodaca18ACDF

Am J Case Rep In Press; DOI:   :: ID: 941946

Available online: 2023-11-15, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
In the 18th century, Morgagni described membranous dysmenorrhea as the sudden and complete detachment of the decidua during menstruation. This causes intense and painful contractions of the myometrium, aggravated by the expulsion of tissues produced by the decidualization of the endometrium. It is a rare pathology associated with oral contraceptives, ectopic pregnancies, abortions, and natural cycles, with consequent thickening and endometrial decidualization with molding of the tissue of the uterine cavity of membranous appearance. The definitive diagnosis is made by histopathological examination.
CASE REPORT
A 43-year-old female patient came for urgent consultation for an acute picture of severe pain in the lower abdomen, radiating to the genital area with transvaginal bleeding of 2 h of evolution. She had no significant past medical history. A transvaginal ultrasound was performed and showed an unchanged endometrial cavity. A vaginal examination revealed a foreign body of soft consistency; therefore, a speculum examination was performed, which showed tissue of endometrial origin located in the cervical canal of a reddish spongy texture. The tissue was removed, thus improving the symptomatology, and was sent to the pathological anatomy service for histopathologic diagnosis.
CONCLUSIONS
Membranous dysmenorrhea is a rare gynecologic disorder with only a few documented cases. According to other case reports, our patient’s case, at age 43 years, was an atypical presentation. The clinical features and association with this pathology allowed the diagnosis and its confirmation by histopathological examination.

Keywords: Abdominal Pain; Case Reports; Endometrial Hyperplasia

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923