Vaginal foreign body: Difference between revisions
ClaireLewis (talk | contribs) (Created page with "==Background== *Patients may be reluctant to provide history due to fear or embarrassment *Foreign bodies most commonly found to be: **Retained tampon **Sex toys or other ite...") |
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==Clinical Features== | ==Clinical Features== | ||
*Vaginal discharge, chronic | *[[Vaginal discharge]], chronic | ||
**Often malodorous | **Often malodorous | ||
**Consider foreign body in all prepubertal patients with discharge, especially if bloody or brown | **Consider foreign body in all prepubertal patients with discharge, especially if bloody or brown | ||
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*Infection | *Infection | ||
**[[Bacterial Vaginosis]], [[Trichomonas]], [[chlamydia]]/[[gonorrhea]] infection, [[Candida Vaginitis]] | **[[Bacterial Vaginosis]], [[Trichomonas]], [[chlamydia]]/[[gonorrhea]] infection, [[Candida Vaginitis]] | ||
**Endometritis, [[PID]], [[TOA]] | **[[Endometritis]], [[PID]], [[TOA]] | ||
*Ob/gyn conditions | *Ob/gyn conditions | ||
**[[Ectopic pregnancy]], abortion (threatened, incomplete, or septic) | **[[Ectopic pregnancy]], [[spontaneous abortion|abortion]] (threatened, incomplete, or [[septic abortion|septic]]) | ||
**Pelvic thrombophlebitis | **Pelvic [[thrombophlebitis]] | ||
**[[Ovarian torsion]], ovarian cyst hemorrhage/rupture | **[[Ovarian torsion]], [[ovarian cyst]] hemorrhage/rupture | ||
**Dysmenorrhea, [[endometriosis]] | **Dysmenorrhea, [[endometriosis]] | ||
*Genitourinary | *Genitourinary | ||
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*Children <7yo or uncooperative patients may require vaginoscopy in the OR with anesthesia | *Children <7yo or uncooperative patients may require vaginoscopy in the OR with anesthesia | ||
*Plain films sometimes help identify radiopaque objects | *Plain films sometimes help identify radiopaque objects | ||
*Some items may be identifiable on ultrasound or MRI | *Some items may be identifiable on [[ultrasound]] or [[MRI]] | ||
==Management== | ==Management== | ||
Revision as of 18:43, 4 October 2019
Background
- Patients may be reluctant to provide history due to fear or embarrassment
- Foreign bodies most commonly found to be:
- Retained tampon
- Sex toys or other items used for sexual stimulation
- Packets of drugs
- Toilet paper
- Pieces of cloth or small toys (in young girls)
Clinical Features
- Vaginal discharge, chronic
- Often malodorous
- Consider foreign body in all prepubertal patients with discharge, especially if bloody or brown
- Vaginal bleeding
- Vulvovaginitis
- Pelvic pain
Differential Diagnosis
- Infection
- Bacterial Vaginosis, Trichomonas, chlamydia/gonorrhea infection, Candida Vaginitis
- Endometritis, PID, TOA
- Ob/gyn conditions
- Ectopic pregnancy, abortion (threatened, incomplete, or septic)
- Pelvic thrombophlebitis
- Ovarian torsion, ovarian cyst hemorrhage/rupture
- Dysmenorrhea, endometriosis
- Genitourinary
- Gastrointestinal
Evaluation
- Visualization may be aided by irrigation with normal saline
- Children <7yo or uncooperative patients may require vaginoscopy in the OR with anesthesia
- Plain films sometimes help identify radiopaque objects
- Some items may be identifiable on ultrasound or MRI
Management
- Remove object, either manually or with saline irrigation