CHRONIC UTERINE INVERSION ASSOCIATED WITH FIBROID - A CASE REPORT

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
J. K. Goel ◽  
Shanti Sah ◽  
Shashi Bala Arya ◽  
Ruchica Goel ◽  
Nandini Agarwal
Keyword(s):  
Case Report ◽  
Coming Out ◽  
Uterine Prolapse ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Lower Abdomen ◽  
Uterine Inversion ◽  
History Of ◽  
Fibroid Polyp

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.

Chronic Inversion of Uterus Following Spontaneous Abortion: A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 41-43
Author(s):  
Tara Manandhar ◽  
Deepa Shah ◽  
Pappu Rijal
Keyword(s):  
Coming Out ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Trimester Abortion ◽  
Uterine Inversion ◽  
Pain Abdomen ◽  
Threatening Condition ◽  
Lower Pain ◽  
Life Threatening ◽  
History Of

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.

scholarly journals Uterus-sparing myomectomy for idiopathic uterine pyomyoma in a young woman: A case report

2020 ◽  
Vol 2 (2) ◽  
pp. 19-22
Author(s):  
Ugur Sen ◽  
Tuğba Karadeniz ◽  
Emrah Beyan
Keyword(s):  
Risk Factor ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Proper Treatment ◽  
Imaging Findings ◽  
Cervical Stenosis ◽  
Mortality And Morbidity ◽  
Risk Of Mortality ◽  
History Of

Pyomyoma, or suppurative leiomyoma, is a rare but serious complication of uterine fibroids. The mechanism of pyomyoma is an infection caused by microorganisms coming from ascending or hematogenously on the ground of necrosis following ischemia and infarction. It can be seen during the course of pregnancy or after abortion and birth. It can also develop after uterine instrumentation or due to cervical stenosis. Patients often present with pain and fever. It should be considered in cases had no other etiology of fever and had a history of uterine fibroids. Diagnosis and treatment are often delayed due to non-specific presentation and imaging findings. This delay increases the risk of mortality and morbidity such as fertility loss. In the vast majority of these cases, total abdominal hysterectomy is required. The case we presented is a premenopausal and sexually inactive woman without any history of pregnancy or uterine instrumentation or immunocompromised. This patient is the 5th case of pyomyoma without risk factor and the 3rd case that was successfully treated with myomectomy. Knowing the proper treatment of pyomyoma will be beneficial to prevent potential mortality and morbidity.

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.

scholarly journals Non Puerperal Uterine Inversion Secondary to Submucosal Fibroid: A Case Report

2021 ◽  
Author(s):  
Nilaj Bagde ◽  
Sefali Shinde ◽  
Vinita Singh ◽  
Rahul Satarkar ◽  
Habung Yarang
Keyword(s):  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Packed Red Blood Cells ◽  
Submucous Myoma ◽  
Uterine Inversion ◽  
Satisfactory Condition ◽  
Fibroid Polyp ◽  
Uncommon Condition ◽  
Vaginal Canal

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.

scholarly journals A Case of Giant Fibroid Uterus

2016 ◽  
Vol 27 (1) ◽  
pp. 27-30
Author(s):  
Irin Parveen Alam ◽  
Rafat Newaz
Keyword(s):  
Uterine Leiomyoma ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Muscle Layer ◽  
Abdominal Hysterectomy ◽  
Severe Anaemia ◽  
History Of ◽  
High Frequency Ultrasonography ◽  
Benign Tumours ◽  
One Year

Fibroids are muscular tumours, the most common benign tumours in females and typically found during the middle and later reproductive years. It originate from the smooth muscle layer of the uterus. Another medical term is leiomyoma or just myoma. It can be as small as an apple seed or as big as a melon. In unusual cases they can become very large. With the advent of high frequency ultrasonography and magnetic resonance imaging it is now possible to diagnose such cases at an early stage1. Asymptomatic uterine fibroids often left untreated. Giant fibroids are the fibroids weighing 11.4kg2,3 or more. Such a fibroid may appear as a solitary tumor or as a conglomerate mass of uterine fibroids presenting as a single uterine tumor4. Giant uterine fibroid are very rare neoplasm and represents a great diagnosis and therapeutic challange. This article illustrates a case of 34 years old woman presented with a four year history of slowly increasing abdominal size with rapid increase in the last one year associated with shortness of breath and severe anaemia by a painless lump. Total abdominal hysterectomy was performed; histologically the specimen was 9.5 kg benign uterine leiomyoma. The patients postoperative evaluation was uneventful and she went back abroad in two months time following operation.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 27-30

scholarly journals Degenerated fibroid - a diagnostic challenge

2016 ◽  
Vol 6 (1) ◽  
pp. 292
Author(s):  
Sonal Bhuyar ◽  
Bhavana Sontakke ◽  
Pooja Mukund Rajbhara
Keyword(s):  
Ovarian Tumor ◽  
Unusual Case ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Large Mass ◽  
Abdominal Hysterectomy ◽  
Diagnostic Challenge ◽  
Malignant Ovarian Tumor ◽  
History Of ◽  
Leiomyoma Of The Uterus

Leiomyoma of the uterus is the most common type of tumor affecting the female pelvis and arises from uterine smooth muscle. The size of leiomyoma varies from microscopic to giant; giant myoma is exceedingly rare. We report an unusual case of a large, cystic, uterine leiomyoma mimicking a primary malignant ovarian tumor on sonography and CT. A 39 year old infertile nulliparous woman presented with a history of lump in abdomen since 2 years and 6 months of amenorrhea. Sonography and CT examination showed a large mass that filled the abdomen. A preoperative diagnosis of a primary malignant ovarian tumor was made. The patient underwent laparotomy with total abdominal hysterectomy preserving tubes and ovaries. The histology revealed a leiomyoma with extensive hyaline degeneration. The current established management of uterine fibroids may include expectant, surgical, or medical management or uterine artery embolization or a combination of these treatments. A surgical approach is preferred for management of giant leiomyomas. Leiomyomas should be considered in the differential diagnosis of a multilocular and predominantly cystic adnexal mass.

scholarly journals Abdominal skin metastasis in endometrial cancer

2019 ◽  
Vol 27 (2) ◽  
pp. 84
Author(s):  
Eccita Rahestyningtyas ◽  
Pungky Mulawardhana ◽  
Tomy Lesmana
Keyword(s):  
Endometrial Cancer ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
Comprehensive Management ◽  
High Risk Factors ◽  
History Of ◽  
Anatomical Pathology

Objectives: Surgical wound metastases in stage 1 endometrial cancer are possible, with a variety of different pathophysiological possibilities. Comprehensive management is needed to keep the patient on the possibility of a good prognosis.Cases Report: During January 2015 – January 2018 at dr. Soetomo Hospital, there were 2 cases of metastatic endometrial cancer in the laparotomy wounds by which the condition is very rare. Case 1, The patient was diagnosed with endometrial carcinoma following the results of curettage. Anatomical pathology examination was done and obtained grade 2 endometrioid adenocarcinoma. In Case 2, the patient underwent Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy in 2013 at Mojokerto General Hospital, indicating Uterine Fibroids and Ovarian Cysts. The results of anatomical pathology examination were unknown. On April 2017, the patient complained abdominal swelling since 3 months ago.Conclusion: In January 2015 - January 2018, 2 cases of metastatic endometrial cancer was found in a former laparotomy operation where this condition is very rare in endometrial cancer cases with low grade ,so that follow-up, monitoring and more vigilance are required in patients with low-grade endometrial Ca who have finished undergoing a surgery and chemotherapy. Rapture or mass resection, followed by external radiation, may be performed in patients with recurrence in the laparotomy wound area or in patients with high risk factors for endometrial cancer such as a history of estrogen use, tamoxifen, nullipara, obesity, diabetes mellitus, and family history of endometrial cancer. Currently, there is no fixed procedure (guideline) in RS. Dr. Soetomo to overcome recurrences especially in the scars of cancer surgery.

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

2020 ◽  
Vol 10 (1) ◽  
pp. 419
Author(s):  
Michelle Fonseca ◽  
Ashwini Desai ◽  
Deepali Kapote ◽  
Swati Gawai ◽  
Anam Syed
Keyword(s):  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Clinical Findings ◽  
Rare Occurrence ◽  
Uterine Inversion ◽  
Fibroid Polyp ◽  
Inside Out ◽  
Multiparous Female ◽  
Uterine Fundus

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.

scholarly journals Non-puerperal uterine inversion due to huge submucosal uterine myoma: a case report

2021 ◽  
Vol 10 (10) ◽  
pp. 3958
Author(s):  
Simeon C. Amadi ◽  
Peter A. Awoyesuku ◽  
Basil O. A. Altraide ◽  
Chinweowa Ohaka
Keyword(s):  
Case Report ◽  
Vaginal Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Rare Clinical Entity ◽  
Diagnosis And Management ◽  
Uterine Inversion ◽  
Ischaemic Necrosis ◽  
Vaginal Myomectomy ◽  
Future Management

Uterine inversion is a rare clinical entity with challenging diagnosis and management. Reports of successfully managed cases contribute to knowledge and aid future management of cases among practitioners. We report a case of a 46 year old para-3 with protrusion of a mass from her vagina and vaginal bleeding of 7 days duration. She was managed as a case of chronic uterine inversion. She was resuscitated and had vaginal myomectomy, Haultin’s procedure and subsequently total abdominal hysterectomy due to ischaemic necrosis of parts of the uterus. 

scholarly journals Abnormal Contour Huge Uterine Fibroids

2016 ◽  
Vol 27 (2) ◽  
pp. 49-50
Author(s):  
Parveen Ahmed ◽  
GM Farid ◽  
Tanveen Ishague ◽  
Ayesha Siddiqua
Keyword(s):  
Genital Tract ◽  
Benign Tumor ◽  
Female Genital Tract ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Ultrasound ◽  
Benign Leiomyoma ◽  
History Of ◽  
Female Genital

Uterine fibroids represent the most common large solid benign tumor of the female genital tract. This 35 years old lady, mother of one child represented to our clinic with a history of progressive abdominal swelling that had rapidly increased in the last two years. There were associated abdominal pain, easy fatigability, heavy menstrual loss and prolong secondary subfertility of about ten years. On examination abdomen was enlarged and the mass measuring about 25cm from xiphisternum, firm, irregular and fairly mobile. Pelvic ultrasound scan revealed features of huge multiple uterine fibroids and the size of the largest one was about 20x25cm,moderate bilateral hydro-nephrosis. Intraoperative findings were moderate pelvic adhesions, huge multiple fibroids and the largest measuring about 18x20cm. Total abdominal hysterectomy with preservation of both ovaries were done. Histopathological report confirmed benign leiomyoma with no evidence of malignancy.Medicine Today 2015 Vol.27(2): 49-50

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