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Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment

VIA procedure Ė Examination before application of acetic acid Ė Normal findings on speculum examination Ė Ectropion

  

Ectropion is visible as a large bright red patch on the ectocervix around the external os. The minute finger-like projections of the villi of the columnar epithelium give it a granular, velvet-like surface. The SCJ is pushed out on the ectocervix and is visible at a variable distance from the external os.





In a very large ectropion, the entire visible part of the cervix appears red and the columnar epithelium occupies almost the entire ectocervix. The SCJ is partially visible at the periphery of the ectropion, sometimes with considerable difficulty.




In the presence of infection or inflammation, the exposed columnar epithelium of an ectropion looks congested, often with visible bleeding points on the surface.






Ectropion is a physiological condition and does not require treatment. Rarely, ectropion may cause postcoital or contact bleeding from the columnar epithelium, which the woman finds troublesome. The exposed columnar epithelium may also cause persistent mucoid vaginal discharge. In such situations, ectropion may be treated with cryotherapy or thermal ablation even though the condition is purely physiological and regresses with age. Destruction of columnar epithelium accelerates the regeneration of epithelium that is squamous in nature. The ectropion is replaced by squamous epithelium within a few months.









The next few sections discuss the abnormalities detected on speculum examination.





























  


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