PDF(Pubmed)
Abstract：
This case report discusses a diagnosis of uterine torsion in an 84-year-old woman who presented with five days of right lower quadrant abdominal pain, nausea, vomiting, constipation, and poor intake. Computed tomography (CT) imaging demonstrated a whorled configuration at the junction of the cervix and lower uterine segment, with the left gonadal vein crossing midline, and two previously known right leiomyomas now appearing on the left. These findings were consistent with the diagnosis of uterine torsion. She then underwent an urgent exploratory laparotomy, and the uterus was found to be dextroverted 270 degrees, with dark mottled purple tissue and engorged vessels. A supracervical hysterectomy and bilateral salpingo-oopherectomy were performed. Final pathology demonstrated extensive necrosis. This case reviews the classic presentation and imaging findings for the rare diagnosis of uterine torsion and options for management of both non-gravid and gravid patients.
摘要：
该病例报告讨论了一名84岁女性子宫扭转的诊断，该女性患有5天的右下腹腹痛。恶心,呕吐,便秘,摄入量差。计算机断层扫描（CT）成像显示在子宫颈和子宫下段的交界处呈轮状构型，左性腺静脉穿过中线，两个以前已知的右侧平滑肌瘤现在出现在左侧。这些发现与子宫扭转的诊断一致。然后她接受了紧急剖腹探查术，子宫被发现是右旋270度，深色斑驳的紫色组织和充血的血管。进行了宫颈上子宫切除术和双侧附件-卵巢切除术。最终病理显示广泛坏死。该病例回顾了罕见诊断子宫扭转的经典表现和影像学发现，以及非妊娠和妊娠患者的治疗选择。
