Torsion of a non-pregnant fibromyomatous uterus

Uterine torsion: a missed diagnosis in young girls?

BACKGROUND

Uterine torsion is considered exceedingly rare in childhood. Nonspecific symptoms of acute torsion may result in missed diagnosis with long-term complications. We report three girls with uterine torsion and argue that the condition is more common than reported.

CASES

Three girls were referred with complex utero-adnexal structural abnormalities diagnosed as an "unusual congenital anomaly." Further evaluation showed uterine torsion as the underlying event. Corrective surgery was effective in preservation of uterine functions in two patients.

CONCLUSIONS

Uterine torsion may not be rare in young girls. Missed diagnosis of the condition has devastating effects, emphasizing the need for high index of suspicion.

A laparoscopic approach to treating torsion of a nonpregnant uterus accompanied by a large ovarian cyst in a premenarchal girl

A 10-year-old premenarchal girl was admitted to our hospital with moderate abdominal pain, although presenting no vomiting or abdominal rebound tenderness. A large abdominal mass was visible and palpable in the periumbilical and epigastric regions. Results of physical examination revealed that the general health status was satisfactory. Computed tomographic scan revealed a large, thin-walled cyst occupying nearly the entire peritoneal cavity. The other viscera were of normal aspect. A laparoscopic approach revealed a left ovarian cystic tumor that was twisted 360 degrees in conjunction with the uterine corpus with hemorrhagic infarction. A partial hysterectomy and a left salpingo-oophorectomy were carried out. The tumor was classified as mature cystic teratoma of the ovary accompanied by hemorrhagic necrosis, not only of the cyst but also of the left uterine tube and the uterine corpus.

Torsion of a nongravid uterus: an unexpected complication of an ovarian cyst

Torsion of nongravid uterus is rare. Most reports occur during pregnancy. A case related to an adnexal mass, is described and the existing literature is reviewed.