Abstracts

The Perils of Post-menopausal Bleed

PGY 48 / Gynaecology

1. Y. Zamzida; KPJ Ipoh Specialist Hospital
2. SH. Syed Rahim; RCMP UniKL
3. GB Hakim; RCMP UniKL

Introduction: This is a case series of 2 ladies in their late 60s, both presenting with post-menopausal bleed. Both were thoroughly investigated (Complete physical exam, Ultrasound-scan of pelvis and abdomen plus Pap smear and DD+C). 1 patient had a normal Pap but DD+C findings of: suspicion of endocervical abnormal cells. TAHBSO was done and HPE showed an early stage endometrial cancer. The 2nd patient had normal Pap and DD+C results but bled persistently for several more months. TAHBSO again showed early stage endometrial cancer.

Conclusion: Post-menopausal bleed should not be taken lightly and must be thoroughly evaluated. Even with a normal DD+C/endometrial sampling result; persistent, un-explained bleed is an indication for hysterectomy.

Keywords: Menopause, bleeding, DD+C, endometrial cancer, Pap Smear