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
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.
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.