Torsion of pedunculated subserous myoma--a rare cause of acute abdomen

Abstract

Leiomyoma uteri are common benign genital neoplasia among women of late reproductive age. Most are asymptomatic. Among those having symptoms, abnormal uterine bleeding and pelvic pressure symptoms are common presenting features. Less common indications for treatment include infertility and abdominal distension. Acute onset severe abdominal pain is an unusual presenting complaint. When present, pain is usually related to complications involving the myoma including red degeneration, infection, process of expulsion of a submucous pedunculated myoma, uterine torsion, compression of myoma between the uterus and sacrum or torsion of a pedunculated subserous myoma. Standard gynecologic textbooks frequently mention torsion of pedunculated subserous myoma as one of the causes of myoma related acute abdomen. Literature search on the topic however does not yield many specific case reports of this myoma related complication or it's presenting features. The condition has not been reported from Ethiopia so far. A case of torsion of pedunculated subserous myoma presenting in early pregnancy that was managed in one of the maternity hospitals in Addis Ababa, Ethiopia is presented.