Non Gravid Uterus Case Study

Title: TORSION OF A NON GRAVID UTERUS
Abstract
Torsion of a non gravid uterus is a rare but potentially fatal event. It may cause irreversible ischemic damage to the uterus leading to rapid clinical deterioration. The rarity of the condition and its non specific clinical presentation make the clinical diagnosis difficult. Here we describe a case of torsion uterus in a 55 year old postmenopausal lady who presented in emergency with acute abdomen. On examination a huge abdominal mass arising from pelvis was noted. The operative finding was huge fundal myoma with uterine torsion.
Keywords: non-gravid, ischemic, torsion, myoma

Introduction
Torsion of the uterus is defined as rotation more than 45 degrees around the long axis. Torsion

Less than 300 cases has been reported over last 150 years.4 However, past two decades have witnessed an increase in reports of torsion of non-gravid uterus indicating more awareness about the diagnosis and increased preoperative use of advanced radiological imaging techniques.5
It is difficult to explain the mechanism of an axial rotation for normal uterus. The uterus in its normal state is firmly held in place by the broad ligaments and the uterosacral ligaments. These supports resist any tendency to torsion. Uterine axial torsion is usually caused by the presence of pathological or abnormal condition in the uterus or the adjacent structures, uterine fibroids being the most common predisposing factor. A large heavy fibroid, especially subserosal, attached near the fundus of the uterus and well above the pelvic brim may rotate and exert traction on the uterus. The relatively weak lateral attachment of the body of uterus which is thus relatively mobile as compared to well supported cervix via lateral cervical and uterosacral ligament may suggest isthmus as a common site of

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