Preoperative diagnosis of the uterine torsion : a case report

TANABE Aya, YAMASAKI Yui, KOH Houu, KOJIMA Nobue, MORITA Hiroki, TANAKA Utaru, TAKEUCHI Kyousuke, TOMURA Yuri

doi:10.11437/sanpunosinpo.73.277

<p>Uterine torsion is defined as a rotation of the uterus more than 45 degrees around the long ais. Because the symptoms of this rare condition are nonspecific, it is difficult to diagnose preoperatively. We here present a patient with uterine torsion that was diagnosed preoperatively. A 78-year-old postmenopausal woman (gravida three, para two) presented with acute abdomen. A pelvic mass was detected by abdominal ultrasonography and she was referred to our hospital for further management. An abdominal CT scan showed an eight-cm-diameter, right-sided, calcified uterine myoma and uterus torsion. A subsequent contrast pelvic MRI examination showed that the uterine myoma that had been on the right side on the abdominal CT was on the left. Thus, the uterine body had twisted and was suspected of being ischemic. Emergency laparotomy was performed with a provisional diagnosis of necrosis of the myometrium caused by 630 degree uterine torsion. Total hysterectomy and bilateral adnexectomy were performed. The postoperative course was uneventful and the patient was discharged on the ninth postoperative day. Uterine torsion is thought to result from the presence of asymmetric fibroids and weakening of the uterine supporting tissue with age. It is therefore important to consider the possibility of uterine torsion for older patient with acute abdomen. [Adv Obstet Gynecol, 73 (3) : 277-282, 2021 (R3.8)]</p>

Preoperative diagnosis of the uterine torsion : a case report

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