13.05.2020 Cases I've never seen Part 1 - Cysts and Voodoo abortion

I wish I had some diagnosis I could make here but with limited resources and my lack of extraordinary medical knowledge I'm a little overwhelmed.  Given she had no pain, no bleeding, no signs of infection upon gynecological examination we referred her to a larger hospital with an internal medicine department.  (I wonder if its one of these many tropical diseases or something like echinococcus multilocularis?)  Well I hope the collegeauges at the university hospital with more tropical knowledge can help her out.  

Help:  What is this? Its a vertical abdominal scan.  On the left a picture of the uterus filled with what looks like a three level cyst  The urinary bladder is filled also with a cyst, round on the right.

A closer look at the uterine cyst

Uterus filled with cysts and looking again like a molar pregnancy, which I have seen far too often here! Her pregnancy test was negative so it wasn't that.

This is a vaginal scan showing the measured cyst in the uterus und additionally in the douglas space on the bottom of the picture.

The other case today was one I haven’t dealt with either before.  A patient came from far away out of our area, which is unusual for here, with a partially dried up umbilical cord presenting between in her vulva.  We were informed that she lost the baby yesterday. Ultrasound showed an intact placenta and no bleeding.  I later found out that it had been a bush abortion in which the patient drinks herbal mix along with some ceremonial acts and after 2 days a person known as a ‘matron’ does the procedure by placing a urinary catheter in the cervix and dilating it so it is big enough for her hand to fit in.  She removes the fetus but most often is not able to remove the placenta.  Many women here die from this kind of procedure due to excessive bleeding or infection in the following days.  Here we prepared for a curettage in anesthesia.  I called my resident and medical student for this teaching opportunity.  The procedure went fine and we gave antibiotics, no idea under what conditions the previous intervention took place.  Many like her are not as lucky to have the necessary medical care as provided by MHM and the team.