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

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  • Case: 51

  • Age: 35

  • Before application of acetic acid: Polyps are seen on the posterior lip and one is close to the SCJ. Nabothian cysts are present at the 11 o’clock and 6 o’clock positions.

  • Cervix before application of acetic acid:  
  •  Infective vaginal discharge:   
    Strawberry appearance of cervix
    Cervicitis
    Polyp
    Bleeding on contact
    White patch
    Growth
    Ulcer
    Erosion

    After application of acetic acid: The SCJ is fully visible. No acetowhite area in the TZ. The polyp is still visible and is partially hiding the TZ.

  • Cervix after application of acetic acid:
    • Squamocolumnar junction visibility:  
    • Squamocolumnar junction location:  
    • Acetowhite area:  

  • VIA category:  

  • Determined eligibility for ablative treatment (if HPV-positive):  

  • Histopathology: Not done

  • Remarks: Polyps or nabothian cysts located close to the external os may interfere with complete visualization of the SCJ. Gentle manipulation with a small cotton swab (soaked in acetic acid) often helps to visualize the SCJ fully. Ablative treatment can be performed only after removal of the polyp.





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