scholarly journals A case of non-pueperal chronic uterine inversion managed successfully

Author(s):  
Michelle Fonseca ◽  
Ashwini Desai ◽  
Deepali Kapote ◽  
Swati Gawai ◽  
Anam Syed

Uterine inversion is prolapse of the uterine fundus and corpus turned inside out towards or through the cervix. The non-puerperal type of uterine inversion is a quite rare occurrence and it accounts for only 17% of all uterine inversion cases. We present a case of 45 year old multiparous female who presented to us with polymenorrhagia with fibroid polyp. Ultrasonography confirmed the clinical findings however Intraoperatively examination under anaesthesia revealed uterine inversion. On table we proceeded with Haultains method of uterine reposition followed by total abdominal hysterectomy. Patient recovered well and thus case was successfully managed.

1970 ◽  
Vol 1 (2) ◽  
pp. 51-54
Author(s):  
Kesang D Bista ◽  
Ashma Rana ◽  
Geeta Gurung ◽  
Neelam Pradhan ◽  
Archana Amatya

How the largest of the large (> 10 x 8 cms) sub mucous myoma arising from the fundus uteri successively promotes the occurrence of non puerperal uterine inversion over the years as depicted through 3 different illustrations imitating a gradual process; first by forming an indentation in the uterine fundus then progressively causing more dimpling in the verge of uterine inversion until finally giving rise to a full blown picture of complete uterine inversion where the uterine fundus is driven beyond the level of introitus with the consequences of prolapsed incarcerated myoma in a post menopausal woman. A total abdominal hysterectomy and bilateral salpingoophorectomy were performed on all of these 3 women 2 perimenopausal and a postmenopausal; the latter was first facilitated by vaginal myomectomy further supplemented by division of the inversion ring posteriorly as described by Haultain. Key words: Non puerperal uterine inversion, submucous fundal myoma, vaginal myomectomy. doi:10.3126/njog.v1i2.2398 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 51-54 Nov-Dec 2006


Author(s):  
Nilaj Bagde ◽  
Sefali Shinde ◽  
Vinita Singh ◽  
Rahul Satarkar ◽  
Habung Yarang

Non Puerperal Uterine Inversion (NPUI) is a very uncommon condition. The incidence of puerparal uterine inversion make an estimate of 1/30,000 deliveries and NPUI approximately 17% of all uterine inversion. The most common cause which leads to uterine inversion is a submucous myoma attached to the fundus but diagnosis can be difficult to make. The management of uterine inversion is always challenging for a surgeon. In the present case a 38-year-old woman, presented with significant anaemia because of menorrhagia. She used to feel mass occasionally into the vaginal canal which never comes out of the introitus, the mass was elucidated as a fibroid polyp. On investigation, her haemoglobin was 6.6 gm%, with continous bleeding per vaginum, patient was transfused with three units packed red blood cells and planned for surgery. A diagnosis of incomplete uterine inversion secondary to a submucous fibroid was made at exploratory laparotomy. Total abdominal hysterectomy, right salpingectomy with left salpingo-oophorectomy was performed. The patient was discharged under satisfactory condition.


2016 ◽  
Vol 1 (2) ◽  
Author(s):  
J. K. Goel ◽  
Shanti Sah ◽  
Shashi Bala Arya ◽  
Ruchica Goel ◽  
Nandini Agarwal

Introduction: Uterine inversion is a condition in which the uterus turns inside out with prolapse of fundus through the cervix into or outside vagina. Chronic inversion cases are rare. We present a rare case of chronic uterine inversion associated with uterine fibroids. Case Report: A 42 year old female, P3 L3 , was admitted with complains of menorrhagia and pain 3 3 lower abdomen for 1 month. Speculum examination revealed a fleshy polyp filling whole of vagina. Upon per vaginal examination size of mass could not be assessed and cervical lips could not be felt. So, a provisional diagnosis of fibroid polyp was made. Per-operatively inversion of tube and ovaries along with a sessile submucosal fundal fibroid polyp of size 10 x 8 cm was found. A revised diagnosis of chronic uterine inversion with sessile fibroid polyp was made. Patient then underwent Total Abdominal Hysterectomy with bilateral Salpingooophrectomy. Conclusion: Chronic inversion should be kept as a differential diagnosis in a patient with history of irregular bleeding associated with dragging pain of lower abdomen and feeling of a mass coming out of introitus. Pre operatively it should be differentiated from fibroid polyp, uterine prolapse and prolapsed hypertrophied ulcerated cervix.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Asiphas Owaraganise ◽  
Leevan Tibaijuka ◽  
Joseph Ngonzi

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.


Author(s):  
Snehal G. Murde ◽  
Rohini R. Raut ◽  
Beena Kumari ◽  
Dinesh C. Hojai

Non puerperal uterine inversion is a very rare clinical scenario with very few gynaecologist actually managing it in their lifetime. Acute variety of non-puerperal inversion is even rarer and thus possess diagnostic and management challenges. Case study of a rare case of a 45 years old female who was admitted for an elective surgery and had sudden acute inversion of uterus which was clinically diagnosed. Patient was managed by debulking of tumour which turned out to be large leiomyoma, followed by total abdominal hysterectomy. Rarity of the disease, atypical symptoms and less clinical exposure to such cases pose diagnostic as well as surgical challenges as in our case.


2020 ◽  
Vol 5 (8) ◽  

Background: Non-puerperal uterine inversion (NPUI) is an extremely rare condition. Most reported cases of uterine inversion ware in multiparous women. Moreover, non-puerperal uterine inversion usually occurs when there is a benign or malignant uterine mass present. In literature, there have been only 9 reported cases of non-puerperal uterine inversion in a nulliparous woman in the 10 year window from 2006 to 2017 [1]. Case: Here, a case of non-puerperal uterine inversion is discussed. Initially the patient was diagnosed as a sub-mucosal fibroid of the uterus. The diagnosis of Non-puerperal uterine inversion was made only during operation. But the case reported in this paper, is the first reported case in a patient who did not have any uterine mass and also was nulliparous. At first, an attempt to reposition the uterus was made by Huntington method but was failed. Then, it was decided to perform the total abdominal hysterectomy. Her postoperative period was uneventful and she was discharged without complication after only seven days. Conclusion: Non-puerperal uterine inversion is rarely encountered by Gynecologist. However, the rare occurrence of this case is often difficult to diagnose, especially when the exact cause of the condition is not known preoperatively. Our patient was lean, thin and malnourished, suffered from general weakness for long time. Could the weakness of the uterine muscle and ligaments be the cause for inversion? The reported case provides an indication for future research on the causes of nonpuerperal uterine inversion, specifically the scenario which has no association to uterine mass in a nulliparous woman.


2020 ◽  
Vol 3 (2) ◽  
pp. 41-43
Author(s):  
Tara Manandhar ◽  
Deepa Shah ◽  
Pappu Rijal

Uterine inversion is a rare entity but poses a serious threat if not diagnosed and managed timely. Here we present a case of chronic uterine inversion in a 30-year-old lady who presented in emergency with a mass coming out per vagina, blood mixed vaginal discharge, and lower pain abdomen for the last 15 days. She underwent laparotomy and was found to have uterine inversion. The patient was attempted for repositioning of uterus with the Huntington’s approach, but it was unsuccessful, hence Haultain’s operation was done with a total abdominal hysterectomy and bilateral salpingectomy with right-sided ovarian cystectomy for a dermoid cyst. Our case emphasizes the importance of keeping chronic uterine inversion as a differential diagnosis in women presenting with pain abdomen, mass, and bleeding per vagina, and with a recent history of second-trimester abortion. Timely recognition, especially in chronic inversion, will decrease the morbidity and mortality associated with this rare but life-threatening condition.


Author(s):  
Sadjia Bekal ◽  
André Vincent ◽  
Alex Lin ◽  
Josée Harel ◽  
Jean-Charles Côté ◽  
...  

Necrotizing fasciitis is a serious disease characterized by the necrosis of the subcutaneous tissues and fascia.E. colias the etiologic agent of necrotizing fasciitis is a rare occurrence. A 66-year-old woman underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. She rapidly developed necrotizing fasciitis which led to her death 68 hours following surgery. AnE. colistrain was isolated from blood and fascia cultures. DNA microarray revealed the presence of 20 virulence genes.


2019 ◽  
Vol 12 (6) ◽  
pp. e229311 ◽  
Author(s):  
Katherine Jane Chua ◽  
Ricky Patel ◽  
Armina Eana ◽  
Joyce Varughese

Uterine torsion is an uncommon entity that is defined as a rotation of greater than 45° around the longitudinal axis of the uterus. Although cases of uterine torsion among pregnant patients have been mentioned in the literature, torsion of a non-gravid uterus is a rare occurrence. A 73-year-old nulliparous woman with a known fibroid uterus underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy with frozen section of a 17–18 cm pelvic mass seen on CT imaging. The source of the pelvic mass was unclear on imaging, and benign and malignant possibilities were discussed. During the procedure, necrosis of the uterine fundus and bilateral adnexa were seen due to the fundus being torsed with the uterine fibroid being the pivot point. Uterine torsion, though rare, can be the cause of acute pelvic pain in a postmenopausal woman.


2018 ◽  
Vol 1 (2) ◽  
pp. 53-55
Author(s):  
Rajiv Shah ◽  
A.M. Samal

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.


Sign in / Sign up

Export Citation Format

Share Document