Uterine torsion in an elderly woman with a large leiomyoma : a case report

DOI Web Site
  • MATSUTANI Kazuna
    Department of Obstetrics and Gynecology, Osaka General Medical Center
  • GOA Satoko
    Department of Obstetrics and Gynecology, Osaka General Medical Center
  • KITAJIMA Yuka
    Department of Obstetrics and Gynecology, Osaka General Medical Center
  • SUMIKURA Tomoko
    Department of Obstetrics and Gynecology, Osaka General Medical Center
  • IWAMIYA Tadashi
    Department of Obstetrics and Gynecology, Osaka General Medical Center
  • KOUDA Mayuko
    Department of Diagnostic Imaging, Osaka General Medical Center
  • FUSHIMI Hiroaki
    Department of Pathology, Osaka General Medical Center
  • TAKEMURA Masahiko
    Department of Obstetrics and Gynecology, Osaka General Medical Center

Bibliographic Information

Other Title
  • 巨大子宮筋腫による子宮捻転を発症した高齢女性の1例
  • キョダイ シキュウ キンシュ ニ ヨル シキュウ ネンテン オ ハッショウ シタ コウレイ ジョセイ ノ 1レイ

Search this article

Abstract

<p>Currently, approximately 200 cases of uterine torsion are reported in the available literature and most of these are known to have occurred during pregnancy. We report a rare case of uterine torsion, which occurred as a complication of a large uterine leiomyoma in an elderly woman. A 72-year-old woman diagnosed with schizophrenia presented with a several-day history of severe abdominal pain. Although she was diagnosed with chronic kidney disease and anemia, she refused medical evaluation for self-neglect. On admission, physical examination showed a mobile, hard and tender abdominal mass (approximately the size of an adult's head) on palpation. Laboratory test results revealed renal failure (serum creatinine 8.63 mg/dl, potassium 8.5 mmol/l) and severe macrocytic anemia (serum hemoglobin 4.3 g/dl, mean corpuscular volume 100.8 fl). Computed tomography revealed an ischemic uterine corpus containing a leiomyoma (20 cm in diameter), suggestive of uterine torsion. Laparotomy was performed following blood transfusion and reduction in serum potassium levels. Intraoperatively, we observed that the uterus was twisted 540° at the lower segment with bilateral dark red and atrophic adnexae, which showed gangrenous changes. We performed supracervical hysterectomy with bilateral salpingo-oophorectomy. The patient's postoperative course was uneventful except that she required temporal hemodialysis. Although torsion of the non-pregnant uterus is extremely rare, it should be considered in the differential diagnosis of acute abdominal pain in postmenopausal women with large uterine leiomyomas. [Adv Obstet Gynecol, 74(1) : 64-69, 2022 (R4.2)]</p>

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top