Torsed subserous uterine leiomyoma

Case contributed by Martin Saenz Aguirre
Diagnosis certain

Presentation

Acute severe refractory abdominal hypogastric pain. She denies fever or any other symptoms. Laboratory markers showed elevated inflammatory parameters. She has no significant previous medical history.

Patient Data

Age: 50 years
Gender: Female

The uterus is enlarged and irregular due to the presence of multiple uterine intramural and subserous leiomyomas. One of them in the posterior aspect of the uterus lacks internal contrast-uptake and is associated with mild inflammatory changes of the surrounding fat. A small amount of pelvic free fluid is also noticed.

Two years prior

ct

Note the normal internal contrast-uptake and the smaller size of the previously mentioned posterior subserous leiomyoma. There are neither inflammatory changes in the pelvic fat nor free fluid.

Case Discussion

This was a surgically proven case of torsion of a pedunculated subserous uterine leiomyoma.

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