Post menopausal vaginal bleeding due to vaginal wall leech infestation

A 50 year old para vi patient was referred to Mekelle Hospital on October 23, 1992 with post menopausal vaginal bleeding and haemorrhagic shock to rule out endometrial carcinoma. She was anaemic. Speculum examination revealed a darkish mass attached to the posterior vaginal fornix. The mass was instilled with about 5 ml (1%) Lidocaine, after which it detached itself and started movement. The mass was an aquatic leech. Previously, post menopausal vaginal bleeding due to leech infestation was not reported, and therefore, this has to be included in the differential diagnosis of abnormal vaginal bleeding. Emphasis should also be made to create awareness among professionals working in areas where leech infestation is prevalent.