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Case Reports
. 2023 Feb 3;102(5):e32838.
doi: 10.1097/MD.0000000000032838.

Pedunculated subserosal leiomyoma with torsion, a rare cause of abdominal pain: A case report

Ching-Tang Chang  1 , Sieh-Yang Lee  2 , Ching-Di Chang  2
Affiliations
Case Reports

Pedunculated subserosal leiomyoma with torsion, a rare cause of abdominal pain: A case report

Ching-Tang Chang et al. Medicine (Baltimore). .

Abstract

Introduction: Acute abdominal pain caused by torsion of the pedunculated subserosal leiomyoma is rare. Miss diagnosis can lead to ischemia, necrosis, and subsequent peritonitis which may cause significant morbidity. Torsion of the leiomyoma should be recognized as a surgical emergency and once suspected, early surgical intervention should be considered.

Patient concerns: A 28-year-old woman with a medical history of uterine leiomyoma presented to our emergency department because of acute onset right lower abdominal pain.

Diagnoses: The computed tomography was performed which demonstrated multiple leiomyomas of variable sizes and a subserosal leiomyoma located at right lower abdomen with poor contrast enhancement.

Interventions: The gynecologist was consulted, and myomectomy was performed. The intraoperative finding showed a pedunculated subserosal leiomyoma with torsion.

Outcomes: She underwent myomectomy for the twisted pedunculated subserosal leiomyoma as well as other leiomyomas and was discharged with a favorable outcome.

Conclusions: Torsion of the leiomyoma is a surgical emergency as delayed in treatment may lead to marked morbidity. Once suspected, the gynecologist must be consulted, and surgical intervention should be considered.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Axial view of CT imaging with contrast enhancement showed a poor contrast enhancement subserosal leiomyoma on right uterine surface (arrow). CT = computed tomography.
Figure 2.
Figure 2.
Coronal view of CT imaging with contrast enhancement showed a poor enhancement subserosal leiomyoma (arrow). CT = computed tomography.
Figure 3.
Figure 3.
The intraoperative finding showed a pedunculated subserosal leiomyoma with torsion and ischemic change.
See this image and copyright information in PMC

References

    1. Baird DD, Dunson DB, Hill MC, et al. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188:100–7. - PubMed
    1. Stewart EA, Cookson CL, Gandolfo RA, et al. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124:1501–12. - PubMed
    1. Munro MG, Critchley HO, Fraser IS; FIGO Menstrual Disorders Working Group. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril. 2011;95:2204–8, 2208.e1. - PubMed
    1. Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015;372:1646–55. - PubMed
    1. Roy C, Bierry G, El Ghali S, et al. Acute torsion of uterine leiomyoma: CT features. Abdom Imaging. 2005;30:120–3. - PubMed

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