scholarly journals Uterine torsion in non-gravid women: A case report and review of cases reported in the last 20 years

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110666
Author(s):  
Harunobu Matsumoto ◽  
Yoko Aoyagi ◽  
Taisuke Morita ◽  
Kaei Nasu
Keyword(s):  
Surgical Intervention ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Leiomyomas ◽  
Emergency Laparotomy ◽  
Resonance Imaging ◽  
Uterine Torsion ◽  
Life Threatening ◽  
Tomography Scan

Uterine torsion is defined as a rotation of >45° around the long axis of the uterus. Uterine torsion is an uncommon event but is even rarer in non-gravid women, with only 25 cases reported in the last 20 years. Here, we report a case of uterine torsion associated with multiple pedunculated subserosal uterine leiomyomas in an 83-year-old woman. She presented at the hospital with lower abdominal pain, and a computed tomography scan revealed multiple uterine leiomyomas with calcifications. Subsequent magnetic resonance imaging raised suspicion for torsion of pedunculated subserosal uterine leiomyomas. Emergency laparotomy was performed, and the patient was diagnosed with uterine torsion with multiple pedunculated subserosal uterine leiomyomas. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The patient’s postoperative course was uneventful. Although difficult to diagnose due to its rarity, uterine torsion can be life-threatening and may cause infertility. Therefore, early diagnosis with imaging and surgical intervention are crucial to avoid serious complications.

scholarly journals Uterine Rupture with Massive Late Postpartum Hemorrhage due to Placenta Percreta Left Partially In Situ

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Mehmet Coskun Salman ◽  
Pinar Calis ◽  
Ozgur Deren
Keyword(s):  
Uterine Rupture ◽  
Bladder Wall ◽  
Placental Tissue ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Wall ◽  
Placenta Percreta ◽  
Emergency Laparotomy ◽  
Life Threatening

Placental adhesive disorders involve the growth of placental tissue into or through the uterine wall. Among these disorders, placenta percreta is the rarest one. However, it may cause significant complications. This report aimed to report a neglected patient with placenta percreta who developed uterine rupture with life-threatening late postpartum intra-abdominal hemorrhage. On admission, the patient had acute abdomen with moderate abdominal distention and was subjected to emergency laparotomy. A full-thickness defect of the anterior uterine wall involving the hysterotomy site was seen. Placental tissues occupied both sides of the incision and posterior bladder wall was also invaded by placenta. Total abdominal hysterectomy with partial resection of the posterior bladder wall was performed.

scholarly journals A Rare Case of Life-Threatening Invasive Mole

2018 ◽  
Vol 1 (2) ◽  
pp. 53-55
Author(s):  
Rajiv Shah ◽  
A.M. Samal
Keyword(s):  
Acute Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Emergency Laparotomy ◽  
Partial Mole ◽  
Life Threatening ◽  
Β Hcg ◽  
Invasive Mole ◽  
Uterine Fundus

A 23-year-old female with a known case of partial mole and under hCG follow up presented with acute abdominal pain and signs of hemoperitoneum. Emergency laparotomy revealed a molar pregnancy perforating through the uterine fundus, resulting in massive haemoperitoneum of 4 litres. Total abdominal hysterectomy was done. The serum β-hCG level regressed following hysterectomy.

scholarly journals ADENEXAL CYSTS

2011 ◽  
Vol 18 (01) ◽  
pp. 32-40
Author(s):  
TEHREEN RIAZ ◽  
SARWAT JABEEN ◽  
WASEEM TALIB ◽  
Nabeela Shami
Keyword(s):  
Demographic Data ◽  
Lower Abdominal Pain ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumour ◽  
Risk Of Malignancy ◽  
Histopathologic Evaluation ◽  
Operative Findings

Objectives: (1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these cases according to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: Medline Study Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed by menstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management.

Cervical Ectopic Pregnancy: Case Report

1970 ◽  
Vol 25 (2) ◽  
pp. 92-94
Author(s):  
Laila Parveen Banu ◽  
Sameena Chowdhury ◽  
Kohinoor Begum ◽  
Ferdousi Islam ◽  
Saria Tasnim
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Naked Eye ◽  
Life Threatening ◽  
Eye Examination ◽  
Cervical Ectopic Pregnancy

A thirty year old lady para 3+0 presented with complaints of amenorrhoea for eight weeks and slight per vaginal bleeding for 28 days with frequent bouts of profuse bleeding. Total abdominal hysterectomy was done. Naked eye examination of the specimen was suggestive of cervical ectopic pregnancy (CEP). Histopathology report confirmed cervical implantation of placenta. CEP is an extremely rare life threatening form of ectopic pregnancy. (J Bangladesh Coll Phys Surg 2007; 25 : 92-94)

scholarly journals Subacute uterine inversion following an induced abortion in a teenage girl: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Asiphas Owaraganise ◽  
Leevan Tibaijuka ◽  
Joseph Ngonzi
Keyword(s):  
Rare Complication ◽  
Hypovolemic Shock ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Unsafe Abortion ◽  
Axillary Temperature ◽  
Uterine Inversion ◽  
History Of ◽  
Failed Surgery

Abstract Background Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. Case presentation We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. Conclusion Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.

Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy

2016 ◽  
Vol 8 (3) ◽  
pp. 236-238
Author(s):  
Farheen Yousuf
Keyword(s):  
South Asian ◽  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Resonance Imaging ◽  
Intrauterine Adhesions ◽  
Ovarian Endometrioma ◽  
Imaging Results ◽  
Endometrial Cavity ◽  
Cut Surface

ABSTRACT Aims To report a case of iatrogenic endometrioses as a result of improper closure of endometrial cavity during myomectomy. Case Report A 30-year-old para 1 has been self-referred to our institution for medical care. A fibroid protruding the endometrial canal was removed 8 months prior to this hospital admission. In less than a month after initial myomectomy, she began experiencing severe pelvic pain more accentuated during menstruation. The pain became progressively worse. The magnetic resonance imaging results are suggestive of ovarian endometrioma. She underwent total abdominal hysterectomy and bilateral salpingo-oophrectomy. Cut surface of uterine cavity shows obliteration of endometrial canal with hourglass constriction. Conclusion Closure of endometrium during myomectomy should be carefully done; keeping an account on patency of endometrial canal is essential to prevent iatrogenic endometriosis. How to cite this article Yousuf F. Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy. J South Asian Feder Obst Gynae 2016;8(3):236-238.

scholarly journals A Case Report of Primary Ovarian Mucinous Adenocarcinoma treated at Dr. Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad

2020 ◽  
Vol 24 (4) ◽  
pp. 430-433
Author(s):  
Jahan Ara Saeed
Keyword(s):  
Abdominal Distension ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uneventful Recovery ◽  
Ovarian Mass ◽  
Resonance Imaging ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
History Of ◽  
Stage 1

Introduction: This is a case of a patient who had a history of grossly increasing abdominal distension for 6 months. The patient had no symptoms except pressure symptoms with a regular menstrual cycle. She initially was investigated as a case of abdominal distension and indigestion. With increasing size, the discomfort was the main symptom. She attended our Gynaecology Outpatient department and was diagnosed as a case of Large Ovarian mass. The first investigation performed was Pelvic ultrasound and Tumour markers and a Risk of malignancy index were calculated. Her Magnetic resonance imaging with contrast showed a large well encapsulated ovarian mass with no ascites and no metastasis. After getting all the investigations and discussion with the patient a Staging Laparotomy with Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed, The ureters were stented before laparotomy to avoid damage to the ureters during surgery. She was diagnosed as Stage 1-A at the time of surgery and had an uneventful recovery. Her histopathology report showed a unilateral Mucinous cystadenocarcinoma with negative peritoneal wash and omentum histopathology.

scholarly journals Post Caesarean Vesicouterine Fistula Causing Menouria

2013 ◽  
Vol 25 (1) ◽  
pp. 46-48
Author(s):  
R Sultana ◽  
N Haque
Keyword(s):  
Fistulous Tract ◽  
Bladder Wall ◽  
Rare Event ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
The Body ◽  
Vesicouterine Fistula ◽  
Fibroid Uterus ◽  
Urogenital Fistula

Vesicouterine fistula is an uncommon urogenital fistula. The incidence is on the rise because of increasing incidence of Caesarean sections. Cyclical Haematuria or Menouria is an important clinical feature of this fistula which may or may not be associated with urinary incontinence depending on the location of the fistulous tract. We present a case report of Post caesarean section Vesicouterine fistula following 2 Caesarean sections. This was successfully managed by laparotomy with repair of fistulous tract in bladder wall and Total Abdominal Hysterectomy for multiple Fibroid uterus done. Menouria is a rare event in Gynecology and one should always keep this possibility in mind when there is cyclical haematuria. A 42 year old Bangladeshi woman was hospitalized with complaints of menorrhagia, lower abdominal pain for last 8 years, cyclical hematuria for last 20 years. She was mildly anemic, haemodynamically stable and regularly menstruating women. The primary Ultrasound scans suggested multiple fibroid with cystic ovary in left side. Cystoscopy was done and findings are a fistulous opening in the bladder measuring around 7mm in size. It was supratrigonal in position. The patient had no history of Endometriosis, Pelvic irradiation therapy, Inflammatory disease, Trauma or Malignancy. Initially there was dilemma in her diagnosis and the patient was diagnosed as a case of bladder Endometriosis besides fibroid uterus. So surgery was planned and Total Abdominal Hysterectomy & bilateral salphingo-oophorectomy done. There was a fistula about 3cm × 2cm in the lower part of the body of uterus connecting with the base of Bladder. Fistula repaired after dissection, patient follow up done and catheter removed after 14 days without any complications. Vesicouterine fistula can be prevented if care is taken to separate the bladder from the uterus during repeat Caesarean sections. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.16072 Medicine Today 2013 Vol.25(1): 46-48

scholarly journals Evaluation of total abdominal hysterectomy over the decade in Holy Family Red Crescent Medical College Hospital - A retrospective observational study

2016 ◽  
Vol 44 (2) ◽  
pp. 87-91
Author(s):  
Rumana Nazneen ◽  
Fahmida Monir ◽  
Salma Yeasmin ◽  
Sharmin Akhter ◽  
Lipy Bakshi ◽  
...  
Keyword(s):  
Observational Study ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Retrospective Observational Study ◽  
College Hospital ◽  
Common Indication ◽  
Medical College ◽  
Life Threatening ◽  
Post Menopausal

Hysterectomy is the commonest major surgical procedure in Gynaecology & usually performed to improve quality of life rather than to cure life-threatening conditions. The rates differ between countries depending on differences in morbidity, health economical aspects, traditions and attitudes. This retrospective observational study was carried out from 2001-2010 & included all cases of abdominal hysterectomy done for benign and non emergency conditions in the department of Obstetrics & Gynaecology, Holy Family Red Crescent Medical College and Hospital, Dhaka with the intention to assess the proportion and the indications of total abdominal hysterectomy over a 10-year period. Percentage of the total abdominal hysterectomy remained between 50-70% of the total major operations over the decade. Fibroid was found to be the most common indication among the admitted patients (around 36%) with highest percetage in 2006 and 2007 (43% and 46% respectively). Next important indication was dysfunctional uterine bleeding (20%) followed by pelvic inflammatory disease (13%), ovarian mass (5%), endometriosis & adenomyosis (4%) and post menopausal bleeding (2%). The majority of hysterectomies were abdominal and the most common indication was uterine fibroids. The overall rate for hysterectomy remained reasonably stable.Bangladesh Med J. 2015 May; 44 (2): 87-91

scholarly journals Uterine Torsion in an Elderly Woman Associated with Leiomyoma and Continuously Elevating Muscle Enzymes: A Case Study and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Hiroko Oda ◽  
Youko Yamada ◽  
Yuriko Uehara ◽  
Tamami Ohno ◽  
Mari Hoya ◽  
...  
Keyword(s):  
Preoperative Diagnosis ◽  
Surgical Intervention ◽  
Elderly Women ◽  
Ct Scanning ◽  
Muscle Enzymes ◽  
Laboratory Findings ◽  
Muscle Enzyme ◽  
Uterine Torsion ◽  
Before And After ◽  
Life Threatening

Uterine torsion is extremely rare in postmenopausal women. Total ischemia of the uterus may cause life-threatening conditions; hence, accurate diagnosis and surgical intervention are crucial. However, preoperative diagnosis is often challenging due to nonspecific clinical features and laboratory findings. We report a case of uterine torsion in a 73-year-old woman who presented with mild but gradually worsening intermittent abdominal pain. During a 5-day observation, repeated blood exams showed elevating serum muscle enzyme levels, lactate dehydrogenase (LDH), and creatinine kinase (CPK), in addition to nonspecific signs of inflammation. Computed tomography (CT) scans were obtained before and after the worsening of symptoms, which revealed changes in size and position of the enlarged uterus with a large leiomyoma, even within a 5-day interval. Based on these findings, the preoperative diagnosis was uterine torsion. Emergency surgery revealed a 540-degree torsion of the uterus at the cervix and uterine body junction. Total hysterectomy and bilateral salpingo-oophorectomy were performed. Plasma muscle enzyme levels normalized after surgery, and the patient recovered without complications. In conclusion, uterine torsion should be considered during differential diagnosis in elderly women with large leiomyoma, even when symptoms are mild. Elevating plasma muscle enzymes may be an indication of uterine torsion; hence, repeated laboratory works and CT scanning should be performed when symptoms progress. Comparison of CT images, taken before and after the worsening of symptoms, may also be relevant for diagnosis. Since uterine torsion may cause rapid deterioration and become life-threatening, early diagnosis and surgical intervention are crucial to avoid serious complications.

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