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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
CASE REPORT
Uterine torsion with necrosis of bilateral adnexa in a postmenopausal woman
  1. Katherine Jane Chua1,2,
  2. Ricky Patel2,
  3. Armina Eana2 and
  4. Joyce Varughese3
  1. 1 Anatomy, School of Medicine, St George’s University, St George’s, Grenada
  2. 2 Obstetrics and Gynecology, Saint Peter’s University Hospital, New Brunswick, New Jersey, USA
  3. 3 Gynecologic Oncology, Saint Peter’s University Hospital, New Brunswick, New Jersey, USA
  1. Correspondence to Dr Katherine Jane Chua, kchua{at}sgu.edu

Abstract

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.

  • obstetrics and gynaecology
  • surgery

https://doi.org/10.1136/bcr-2019-229311

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    Footnotes

    • Contributors KJC and RP both prepared and obtained the data required in drafting the case report. However, with regards to revisions, KJC had taken the lead in addressing the comments made by the reviewers. AE and JV were the primary surgeons involved in the unique case and desired to offer a lesson in determining differential diagnoses with atypical symptoms. In addition, JV is the primary investigator/mentor and guided the manuscript and revisions to reflect the learning objectives from this case. All authors listed discussed the necessary components needed in the manuscript to offer a lesson for future physicians.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.