A case of preoperatively diagnosed uterine torsion with giant uterine fibroids, cervical wall rupture, and secondary omental torsion

KAWAMATA Mari, KITAOKA Yui, KITAMURA Yoshihiro, SAWADA Shigenari

doi:10.11437/sanpunosinpo.74.21

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術前診断できた巨大子宮筋腫を伴う子宮捻転・子宮断裂・大網捻転の1例
ジュツゼンシンダンデキタキョダイシキュウキンシュオトモナウシキュウネンテン・シキュウダンレツ・ダイモウネンテンノ 1レイ

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Abstract

<p>Uterine torsion is not commonly found and is rarely diagnosed preoperatively. We report a case of uterine torsion with giant uterine fibroids, cervical wall rupture, and secondary omental torsion caused by adhesion of the omentum to uterine fibroids. A 53-year-old woman (five gravida, three para) presented to our hospital with lower back and abdominal pain. Contrast- enhanced computed tomography revealed giant uterine fibroids, uterine torsion, and adhesions between the uterine fibroids and the omentum. Laparotomy revealed a three-turn clockwise twist from the uterine body to the cervix and a huge uterine fibroid that developed on the left side of the uterine body. Furthermore, the omentum was twisted and adhered to the fibroid. The cervical wall was ruptured, and the bilateral appendages were highly congested. Supracervical hysterectomy, bilateral adnexectomy, and partial omental resection were performed. The postoperative course was unremarkable. Although uterine fibroids are benign and uterine torsion and its sequelae are rare, uterine torsion can be considered as the cause of acute abdomen in women with large uterine fibroids. [Adv Obstet Gynecol, 74(1) : 21-26, 2022 (R4.2)]</p>

Journal

ADVANCES IN OBSTETRICS AND GYNECOLOGY

ADVANCES IN OBSTETRICS AND GYNECOLOGY 74 (1), 21-26, 2022

THE OBSTETRICAL GYNECOLOGICAL SOCIETY OF KINKI DISTRICT JAPAN

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