Torsion of Non-gravid Uterus: A Life-Threatening Condition in a Postmenopausal Lady

Uterine torsion in non-gravid women: A case report and review of cases reported in the last 20 years

“…Despite its rarity, non-specific symptoms, and laboratory data, uterine torsion was diagnosed in 7 of the 18 (38.9%) cases based on the "whirl sign" of the uterine cervix preoperatively. 2,5,7,8,13,21,23 In our case, the "whirl sign" of the uterine cervix was observed on preoperative MRI. However, we could not diagnose uterine torsion at that time as we had never encountered a patient with this condition; thus, uterine torsion was not considered in the differential diagnosis.…”

“…Cases complicated by progressive renal failure, hemorrhagic shock, or blood transfusion need have been reported. 5 , 10 – 13 Of the eight cases involving premenarcheal and young menstruating women, five (62.5%) lost their fertility after surgery. 4 , 9 , 14 – 16 Since the symptoms were often vague or non-specific, most patients were monitored for a few days to several months until surgical intervention was performed, with or without a preoperative diagnosis of uterine torsion ( Table 1 ).…”

“…However, the most characteristic and common finding is the “whirl sign” of the uterine cervix. 2 , 5 , 7 , 8 , 13 , 21 , 22 “Whirl sign” might be labeled as “whorled structure” or “whirled appearance,” or “twisted cervix” in some reports; however, these descriptions refer to the same finding. The “whirl sign” cannot be observed on ultrasonography; it can only be observed on CT scan and MRI.…”

“…Although uterine torsion is difficult to diagnose due to its rarity and non-specific symptoms and laboratory data, it can be life-threatening and cause infertility. 4 , 5 , 9 – 16 Therefore, early diagnosis and surgical intervention are critical. Here, we report a case of uterine torsion associated with pedunculated subserosal uterine leiomyomas in a non-gravid older woman and present a review of all cases of uterine torsion in non-gravid women reported in the last 20 years.…”

Torsion in Uterus: An Obstetrical and Gynaecological Emergency

“…Whirl sign of the cervix of the uterus is a reliable diagnostic tool for UT, even though it is a rare condition and lacks specific symptoms and laboratory data. Conversely, UT should be scrutinised as a differential diagnosis for women with severe abdominal discomfort, because early diagnosis and management may conserve fertility and avert life-threatening consequences [ 25 - 27 ].…”