Abstract

TORSION OF A HUGE PEDUNCULATED SUBSEROUS UTERINE LEIOMYOMA: CASE REPORT AND LITERATURE REVIEW

Indami Davide Bedansanta*, Benlghazi Abdelhamid, Dembélé Chaka, Baldé M.A, Nabalim Ivaldino, Benali Saad, El Mangoub Fatima, Ait Bouhou Rachid, Elhassani Moulay Mehd and Kouach Jaouad

ABSTRACT

Introduction and importance: Uterine leiomyomas, also known as uterine fibroids, are the most common pelvic tumors in women of childbearing age. The location of leiomyomas is a key factor in the occurrence of specific complications. Torsion of subserous leiomyomas is one of the rarest causes of acute abdomen. Case presentation: We present a case of a 43-year-old woman with intense abdominal pain. Physical and vaginal examinations revealed an enlarged uterus and an abdominopelvic mass. Imaging confirmed a solid, pedunculated mass connected to the uterus. An exploratory laparotomy was conducted, during which a myomectomy was performed. The histological result confirmed the existence of a leiomyoma accompanied by ischemic infarction. Clinical Discussion: Torsion of a pedunculated subserous uterine leiomyoma is an uncommon complication, with an incidence of less than 0.25%. It is considered a surgical emergency due to the potential risks of ischemic gangrene and reactive peritonitis. Accurately diagnosing this condition prior to surgery can be quite challenging. Conclusions: This report highlights the importance of recognizing uterine leiomyoma torsion as a rare cause of acute abdominal pain. Appropriate surgical management can help avoid potential complications and ultimately improve patient outcomes.

Keywords: acute abdomen, Abdominal pain, Subserous leiomyoma, pedunculated fibroid, Torsion, Myomectomy.