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 Table of Contents  
CASE REPORT
Year : 2016  |  Volume : 2  |  Issue : 1  |  Page : 36-37

Rare Occurrence of Paddy Grain as Forein Body in Uterine Cavity in A Case of Prolapsed Uterus


Department of Gynecological Oncology, Indira Gandhi Institute of Medical Sciences, India

Date of Web Publication12-Feb-2016

Correspondence Address:
Sangeeta Pankaj
Additional Professor Gynecological Oncology IGIMS, Patna
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 


Foreign bodies in the genital tract is a commonly encountered in both men and women but more common in women. These are encountered more commonly in the younger age group compared to post menopausal age. Foreign bodies might cause symptoms such as pain or offensive vaginal discharge or might remain asymptomatic. The common location of such foreign bodies is the vagina and are less commonly found within the uterus. Here we report a case of rice grain found inside the uterine cavity of a post menopausal woman with chronic uterovaginal prolapse.

Keywords: Foreign bodies, uterus, rice grain, prolapsed


How to cite this article:
Nazneen S, Kumari A, Kumari S, Kumari A, Kumari J, Pankaj S. Rare Occurrence of Paddy Grain as Forein Body in Uterine Cavity in A Case of Prolapsed Uterus. J Indira Gandhi Inst Med Sci 2016;2:36-7

How to cite this URL:
Nazneen S, Kumari A, Kumari S, Kumari A, Kumari J, Pankaj S. Rare Occurrence of Paddy Grain as Forein Body in Uterine Cavity in A Case of Prolapsed Uterus. J Indira Gandhi Inst Med Sci [serial online] 2016 [cited 2022 Oct 2];2:36-7. Available from: http://www.jigims.co.in/text.asp?2016/2/1/36/303369




  Introduction: Top


Foreign objects in the genital tract of women is a common occurence all over the world.[1] They are commonly found in the vagina and are less common in the uterine cavity. These foreign objects in the genital tract may be placed accidentally or inserted purposefully. When found in young girls the possibility of abuse must be kept in mind. The commonly discovered foreign bodies from the female genital tract are tampons, forgotten intrauterine contraceptive devices, retained bones in the uterine cavity due to incomplete abortion or abortion sticks left inserted inside the uterine cavity for the purpose of criminal abortion. The other objects commonly recovered from the genital tract include seeds, surgical instruments (often forgotten) and sexual aids retained inadvertently[2] drug carriage is more common in international travelers[3]. Patients may or may not be aware of the presence of these objects in their body. These foreign bodies might remain inside the genital tract asymptomatically or might produce symptoms such as vaginal bleeding, offensive discgarge and in extreme cases might lead to serious complications such as perforation of the uterus and injury to adjacent organs. We report a rare case of rise grain found in the uterine cavity in an asymptomatic postmenopausal women with chronic uterovaginal prolapse.


  Case Report: Top


A 65 year old grand multipara from a village in Bihar came to our institute with the complain of something coming out from vagina since 1 year and white discharge on and off since 1 month. The discharge was watery and not associated with foul smell or itching. There were no other complaints. She gave history of 5 normal unattended vaginal home deliveries. Nothing significant was found in her past medical or surgical history. On examination her cervix was seen 5 cm outside the introitus with dry vaginal wall. She had grade 3 cystocele and grade 1 rectocele. On palpation her uterus was atrophic. There was no procidentia. Total vaginal hysterectomy with anterior colporrahaphy and posterior colpoperiniorrhaphy was planned and carried out. On cut section of the uterus a rice grain covered with husk was found inside the lower uterine cavity. The endometrium and myometrium were atrophic and appeared normal. The grain was dark and decaying indicating its retention for a longtime in the uterine cavity. On taking a history it was later found that she belonged to an agricultural family and was engaged in threshing and seiving of rice grains. Postoperative period was uneventful and the patient was discharged on the 5th postoperative day.


  Discussion: Top


Foreign bodies can enter the female genital tract either accidentally or might be inserted purposefully by the woman herself or by someobody else. Insertion of foreign bodies into the vagina is easier and so more commonly seen but uterine insertion is much more difficult and are less common. Uterine insertions are usually done by doctors for the purpose of contraception or insertion of medicated intra uterine devices or by an untrained person or quacks for criminal abortion. Rarely, foreign bodies entering the uterine cavity accidentally have also been reported. Just as a sperm travels long the cervical mucus aided by the ciliary action of the endocervical cells, similarly small foreign objects picked up by the parous cervical os might travel through the cervical canal and reach the uterine cavity. These objects have high chances of getting retained inside the uterine cavity in a postmenopausal women as there is no bleeding which might flush the foreign body out of the uterus. These objects might result in vaginal discharge or even lead to life- threatening complications like pyometra causing sepsis or urinary retention.

In one reported case of unusual foreign body in the uterus, a dead cricket was found inside the uterine cavity with otherwise normal appearing atrophic uterus in a seventy- year-old grand multipara lady with the complaints of something coming out of the vagina since 6 years (utero vaginal prolapse) and difficulty in passing urine and stools and occasional blood stained discharge for 4 months.[4]

Fernandes G et al presented a rare case of an endometrial microscopic foreign body of plant origin with an intense reaction around it and indentation of the endometrial surface.[5] In this case, the prolapsed cervix might have picked up the plant debris from the ground and the microscopic particles might have traveled up the uterus passively.

In a study conducted in Nepal over a period of 10 years on patients undergoing vaginal hysterectomy for uterovaginal prolapse, 15 patients were found to have rice grains in the uterine cavity.6 The grains were 1 to 3 in number and at various locations in the uterine cavity. Pyometra formation causing urinary retention and posing surgical difficulties was observed among two out of fifteen women.

The fact that Nepal and India both are rice cultivating countries increase the incidence of such cases in this region. The women are usually involved in handling of rice crops and thus the chances of a prolapsed cervix picking up the grain is high, moreover the unpeeled rice grian is rough and spikey making it easier to get attached to the cervix.


  Conclusion: Top


Small foreign objects might enter the uterine cavity when they come in contact with the cervix of a prolapsed uterus in a multiparous postmenopausal female. These may be symptomless or may cause mild symptoms like vaginal discharge but may also lead to serious complications like pyometra. So, while managing cases of uterine prolapse associated with symptoms, occurrence of such foreign bodies must be kept in mind.



 
  References Top

1.
Elizabeth V. Mausner, Silaja Yitta, Chrystia M. Slywotzky, Genevieve L. Bennett. Commonly Encountered Foreign Bodies and Devices in the Female Pelvis: MDCT Appearances. AJR 2011; 196:W461- W470  Back to cited text no. 1
    
2.
Yazicioglu, H.F., Yasar, L. and Dulger, O. (2004) Hysteroscopic Removal of a Foreign Body from the Subvesical Space. International Journal of Gynecology & Obstetrics, 86, 48-49. http://dx.doi.org/10.1016/j.ijgo.2004.04.031  Back to cited text no. 2
    
3.
Benjamin, F., Guilaume, A.J., Chao, L.P. and Jean, G.A. (1994) Vaginal Smuggling of Illicit Drug: A Case Requiring Obstetric Forceps for Removal of Drug Container. American Journal of Obstetrics and Gynecology, 171, 1385-1387. http:// dx.doi.org/ 10.1016/0002-9378(94)90168-6  Back to cited text no. 3
    
4.
Pushplata, S., et al. (2014) Bizarre Foreign Objects in the Genital Tract-Our Experience and Review of Literature. Open Journal of Obstetrics and Gynecology, 4,427-431.  Back to cited text no. 4
    
5.
Fernandes G, Parulekar SV. Endometrial Microscopic Foreign Body. JPGO 2014. Volume 1 Number 11.  Back to cited text no. 5
    
6.
Baral J, Rana A, Gurung G. Rice grain in uterine cavity:Rare presentations in rural Nepalese postmenopausal farmer with uterovaginal prolapse. J South Asian Feder Menopause Soc 2014;2(2):79-82  Back to cited text no. 6
    




 

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