Uterine torsion in a non-gravid patient with giant myomatosis: case report

Abstract

Uterine torsion is a rare condition and is considered a gynecological emergency. It consists of the rotation of the uterus on its long axis of more than 45 degrees at the level of the isthmus. It can occur at any stage of a woman's life, premenarche to postmenopause, as a consequence of alteration in uterine support mechanisms associated with predisposing factors of the uterus or adnexa. Uterine torsion in non-pregnant premenopausal women is extremely rare and the most common cause is large leiomyomas. It presents with nonspecific abdominal pain, which makes preoperative diagnosis difficult. There are indirect signs in radiological studies, however they are not precise. The treatment is surgical and will depend on the intraoperative findings, in most cases total abdominal hysterectomy with possible complications such as pulmonary thromboembolism, shock and even death if a timely diagnosis is not made. We report the case of uterine torsion due to pedunculated myoma in a 38-year-old nulliparous patient with persistent abdominal pain in whom conservative surgery was performed.