Abstract
IntroductionInversion of the non-pregnant uterus is rare.Case presentationA 56-year-old African American woman presented to our emergency center with complaints of a mass protruding from her vagina. She subsequently underwent vaginal myomectomy, abdominal hysterectomy and bilateral salpingo-oophorectomy. Pathologic examination revealed a necrotic fibroid and endometrium. At the time of laparotomy an inverted uterus was diagnosed when a 3 cm dimple containing bilateral round ligaments, infundibulopelvic ligaments and bladder was observed.ConclusionChronic nonpuerperal inversion of the uterus is rare. Infection should be suspected and appropriate broad spectrum antibiotics begun while planning surgery. An attempt at vaginal restoration and removal is difficult. Abdominal hysterectomy may be necessary taking care to locate the distal urinary collecting system.
Highlights
Inversion of the non-pregnant uterus is rare.Case presentation: A 56-year-old African American woman presented to our emergency center with complaints of a mass protruding from her vagina
Chronic nonpuerperal uterine inversion is often associated with uterine pathology
Prolapsed fibroids tend to be the most common inciting factor with occasional reports of inversion associated with uterine neoplasm and endometrial polyps [1,3,4,5,6]
Summary
Chronic nonpuerperal inversion of the uterus is uncommon, with little more than 100 reports in the literature. Its presence should be suspected when a larger prolapsed fibroid is encountered. Biopsy of the mass is prudent given its occurrence with uterine malignancy. In chronic inversion secondary to a fibroid, infection of the fibroid and uterus should be suspected. An attempt at vaginal restoration and removal has been reported but is difficult. Abdominal hysterectomy may be necessary, taking care to locate the distal ureters, with intraoperative cystoscopy to ensure bladder and ureteral integrity. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Submit your manuscript to BioMed Central and take full advantage of:
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