A bizarre self inflicted injury resulting in a "Near-Miss” in a Gynaecological case

Abstract

A 32 year old, para 3 woman presented in shock and drowsy condition with bleeding per vaginum. On gaining consciousness, the patient revealed that she had chopped off some part of her gentalia and flushed it. Her previous treatment papers revealed she had been suffering uterine prolapse since last chid birth 3 years back. On examination, cervix could not be seen, and vaginal edges were seen bleeding. After patient stabilization, EUA showed a partially amputated cervix with retracted vaginal edges. A vaginal hysterectomy was done. On cut section of hysterectomy specimen, only 1 cm of cervix was identifiable, and uterus otherwise being normal on gross examination. The post operative period was uneventful. In view of extreme nature of affliction, a history of intoxication was obtained but denied by both husband and the patient. No history of prior psychiatric illness or symptomatology was reported. Psychiatric consultation revealed it to be a case of first episode of psychosis and accordingly antipsychotic treatment was started.