Published 7 January 2009, doi:10.1136/bmj.a2787
Cite this as: BMJ 2009;338:a2787

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Imaging investigation of postmenopausal bleeding

Anju Sahdev, consultant radiologist

1 Barts and London NHS Trust, London EC1A 7BE

anju.sahdev@bartsandthelondon.nhs.uk

The first 150 words of the full text of this article appear below.

A 72 year old woman presented with a two month history of postmenopausal vaginal bleeding. Relevant medical history included insulin dependent diabetes, hypertension, and recent breast cancer. She had been taking tamoxifen for three years.Go


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1 What imaging investigation is shown in the pictureGo?
2 What abnormality is shown?
3 In a postmenopausal woman, what conditions produce these appearances?
4 What does the patient need next?

1 Transvaginal ultrasound scan of the uterusGo.


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  		Fig 1 Transvaginal ultrasound shows endometrial thickening measuring 1 cm.

 
2 Endometrial thickening measuring 1 cm. An acceptable postmenopausal endometrial thickness should be less than 5 mm.
3 Benign endometrial polyps, endometrial hyperplasia, endometrial cancer.
4 The patient requires referral to a cancer centre or unit for full gynaecological evaluation and endometrial sampling to establish the nature of the endometrial thickening.

Postmenopausal bleeding represents 5% of all gynaecology outpatient attendances.1 Transvaginal ultrasound is a highly . . . [Full text of this article]


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