A Case of Left Adnexal Mass

Author: Dr. Girish Gupta

Chief Complaints:
A thirty year old uniparous female was suffering from pain in left hypochondriac region since 1 year and pain in right lumbar region since 2 years.
Obstetric History:

G (gravida) 2 P (para) 1 A (abortion) 1 S (still birth) 0 L (living) 1

Menstrual History:
Menses regular, adequate, lasting 3 days (LMP – 22/8/2011)

Past History:
Ectopic pregnancy operated in 2009

Mental History:
The lady is offended easily and shouting during anger. Her anger gets worse from contradiction and grief. She is brooding in nature. She is always hurried and dissatisfied.

Mentally she is very soft and yielding in nature. She feels better from consolation. She is sentimental and remose. She is very sympathetic to others.

She has anticipatory anxiety. She is dictatorial and censorious. She wants everything neat and clean. She always dwells on past. She can’t take decisions.

Physical Generals:
She has desire for hot and spicy food.

Investigation:
Initial ULTRASONOGRAPHY Report (25/09/2011)

Left adnexa reveals a large well – defined bilocular cystic lesion measuring approximately 85 X 56 X 69 mms (Volume: 174.30 cc) having low level dependent internal echoes.

CA – 125 (25/09/2011): 5.00 U/ml(WNL)

Please share your views. What could be the prescription? She started improving immediately after the administration of the remedy. She cured completely with Homoeopathic treatment.

Case Solution:

Rubrics for Repertorisation:

1. Shouting during anger
2. Offended easily
3. Brooding
4. Anger from contradiction
5. Dictatorial
6. Yielding
7. Dissatisfied
8. Censorious
9. Hurry tendency
10. Grief
11. Fastidious
12. Sentimental
13. Sympathetic
14. Dwells on past
15. Remorse
16. Irresolute
17. Consolation ameliorates
18. Anticipation anxiety
19. Desire for hot food
20. Desire for spicy food

RESULT OF REPERTORISATION

Medicine Selected:
PULSATILLA

Follow-Up:
September 21, 2011:
Pulsatilla 30 weekly was prescribed followed by placebo for 1 week.

September 28, 2011:
LMP– 22/08/2011. Menses yet not appeared. Pain left hypochondriac region remained as such. Pulsatilla 30 was advised weekly followed by Colocynthes 30 twice daily for 3 weeks.

October 21, 2011:
Menses appeared on 18/10/2011 were scanty lasting 2 days. Pain left hypochondriac region reduced. Pulsatilla 30 was advised weekly followed by Colocynthes 30 twice daily for 2 weeks.

November 09, 2011:
Pain left hypochondriac region reduced. Pulsatilla 30 was advised weekly followed by Colocynthes 30 twice daily for 4 weeks.

December 12, 2011:
Menses appeared on 18/11/2011. No further improvement in pain left hypochondriac region. Pulsatilla 200 was advised weekly followed by Colocynthes 30 twice daily for 4 weeks. Patient was advised for repeat ultrasonography of pelvis.

January 16, 2012:
Menses appeared on 09/01/2012 flow was scanty lasted for 2 days.
Ultrasonography of pelvis dated 14.01.2012 revealed decrease in size of left adnexal mass X 39 X 57 mms (Volume : 105 cc). Earlier it was from 85 X 56 X 69 mms with volume of 174.30 cc. Pulsatilla 200 was advised weekly followed by Colocynthes 30 twice daily for 12 weeks on different visits

April 30, 2012:
Menses appeared on 07/04/2012 flow was scanty, lasted for 2 days.
Ultrasonography of pelvis dated 30.04.2012 revealed complete resolution of left adnexal mass.
The case was declared as cured and was advised to come for follow – up at regular interval.