Uterine torsion with necrosis of bilateral adnexa in a postmenopausal woman

Chua, Katherine Jane; Patel, Ricky; Eana, Armina; Varughese, Joyce

doi:10.1136/bcr-2019-229311

Cited by 10 publications

(14 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As in our current case, clinical symptoms that could be decisive factors for surgical intervention, such as intense abdominal pain, rigidity, and rebound tenderness, were frequently absent in elderly patients aged 60 years and over [ 2 , 3 , 6 ] [ 9 , 10 ]. Since the onset of symptoms is often unclear, most patients were observed for 5–7 days until surgical intervention was decided with or without preoperative diagnosis.…”

Section: Discussionmentioning

confidence: 69%

“…Large leiomyoma is a well-known risk factor of uterine torsion in nongravid women. All reported cases of uterine torsion in elderly patients over the age of 60 years involved leiomyoma larger than approximately 15 cm as a maximum diameter [ 2 , 3 , 6 , 9 , 10 ]. Interestingly, previous literature demonstrated that four out of six elderly patients, including our current case, presented with a medical history of hernia before the occurrence of uterine torsion [ 3 , 6 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical presentations may not necessarily reflect the severity of the uterus tissue ischemia. Even in cases with tightly twisted cervix of over 360 degrees, resulting in total blockage of the uterine blood flow, patients' chief complaint was mostly mild abdominal pain [ 6 , 9 , 10 ]. In some cases, surgical interventions were not decided until the patients' condition started to suddenly deteriorate due to massive abdominal hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Uterine Torsion in an Elderly Woman Associated with Leiomyoma and Continuously Elevating Muscle Enzymes: A Case Study and Review of Literature

Oda

Yamada

Uehara

et al. 2020

Case Reports in Obstetrics and Gynecology

View full text Add to dashboard Cite

Uterine torsion is extremely rare in postmenopausal women. Total ischemia of the uterus may cause life-threatening conditions; hence, accurate diagnosis and surgical intervention are crucial. However, preoperative diagnosis is often challenging due to nonspecific clinical features and laboratory findings. We report a case of uterine torsion in a 73-year-old woman who presented with mild but gradually worsening intermittent abdominal pain. During a 5-day observation, repeated blood exams showed elevating serum muscle enzyme levels, lactate dehydrogenase (LDH), and creatinine kinase (CPK), in addition to nonspecific signs of inflammation. Computed tomography (CT) scans were obtained before and after the worsening of symptoms, which revealed changes in size and position of the enlarged uterus with a large leiomyoma, even within a 5-day interval. Based on these findings, the preoperative diagnosis was uterine torsion. Emergency surgery revealed a 540-degree torsion of the uterus at the cervix and uterine body junction. Total hysterectomy and bilateral salpingo-oophorectomy were performed. Plasma muscle enzyme levels normalized after surgery, and the patient recovered without complications. In conclusion, uterine torsion should be considered during differential diagnosis in elderly women with large leiomyoma, even when symptoms are mild. Elevating plasma muscle enzymes may be an indication of uterine torsion; hence, repeated laboratory works and CT scanning should be performed when symptoms progress. Comparison of CT images, taken before and after the worsening of symptoms, may also be relevant for diagnosis. Since uterine torsion may cause rapid deterioration and become life-threatening, early diagnosis and surgical intervention are crucial to avoid serious complications.

show abstract

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Uterine Torsion in an Elderly Woman Associated with Leiomyoma and Continuously Elevating Muscle Enzymes: A Case Study and Review of Literature

Oda

Yamada

Uehara

et al. 2020

Case Reports in Obstetrics and Gynecology

View full text Add to dashboard Cite

show abstract

“…But up till now, uterine torsions due to ibroids are still reported. In fact, Chuan, et al reported last year a case of uterine torsion with necrosis of bilateral adnexa in a postmenopausal woman where a uterine ibroid was present [9].…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic shock due to irreducible uterine torsion in a third trimester twin pregnancy: A case report

Darido¹,

Fesquet²,

Diari³

et al. 2020

Clin J Obstet Gynecol

View full text Add to dashboard Cite

Uterine torsion is a rare life-threatening event that happens at any age or any gestational age. By defi nition, it consists of a rotation of more than 45 degrees around the long axis of the uterus. The reported cases have variable presentations. The uterine torsion can happen without any sequelae either for the fetus or the mother. However, fetal and maternal mortalities were also reported in such a case We hereby, report the case of a 29-year-old female patient, with previous four Normal Vaginal Deliveries, pregnant with twins, presenting at 36 weeks gestation with an irreducible uterine torsion at the third trimester of her pregnancy complicated by maternal and fetal deaths. We concluded that the prognosis is improved as long as the management is done rapidly. More data is needed to know about the genetic predilection and the characteristics of imaging workup for a rapid preoperative diagnosis of this condition.

show abstract

“…increasing the risk of uterine torsion include structural anomalies that distort pelvic anatomy, such as pregnancy, uterine fibroids [4], ovarian cysts [5], and adnexal tumors, and ligamentous laxity in the pelvis [6,7]. Multiple case reports have described torsion either in the gravid uterus [2,6] or in postmenopausal women [7][8][9], yet rarely in the non-gravid, premenopausal uterus.…”

Section: Case Report Peer Reviewed | Open Access Wwwijcriogcommentioning

confidence: 99%

The twisted uterus: A rare presentation of uterine torsion

Stannard¹,

Whittaker²,

Aziz³

et al. 2022

J Case Rep Images Obstet Gynecol

View full text Add to dashboard Cite

Introduction: Uterine torsion is a rare gynecological emergency, defined as torsion of the uterus greater than 45° around its axis. Case reports describe torsion either in the gravid uterus or in postmenopausal women, yet rarely in the non-gravid, premenopausal uterus. This report describes the case of uterine torsion secondary to a large pedunculated fibroid in a 34-year-old nulliparous woman. Case Report:The patient presented with sudden onset of severe left sided abdominal pain which started during mild exertion. On examination she had a tender uterus which was enlarged secondary to a known large pedunculated fibroid. A planned myomectomy had been delayed due to the COVID-19 pandemic. Her pain worsened and therefore she was admitted with a working diagnosis of either torsion of the pedunculated fibroid or fibroid degeneration. A magnetic resonance imaging

show abstract

Uterine torsion with necrosis of bilateral adnexa in a postmenopausal woman

Cited by 10 publications

References 6 publications

Uterine Torsion in an Elderly Woman Associated with Leiomyoma and Continuously Elevating Muscle Enzymes: A Case Study and Review of Literature

Uterine Torsion in an Elderly Woman Associated with Leiomyoma and Continuously Elevating Muscle Enzymes: A Case Study and Review of Literature

Hemorrhagic shock due to irreducible uterine torsion in a third trimester twin pregnancy: A case report

The twisted uterus: A rare presentation of uterine torsion

Contact Info

Product

Resources

About