Halassy Sophia, Clarke David
Department of Obstetrics & Gynecology, Ascension Providence Hospital, Michigan State University College of Human Medicine, 16001 W Nine Mile Road, Southfield, MI 48073, USA.
Case Rep Womens Health. 2019 Dec 24;25:e00170. doi: 10.1016/j.crwh.2019.e00170. eCollection 2020 Jan.
A woman presenting with sudden, severe pelvic pain should prompt an evaluation for torsion, most commonly, ovarian torsion. Uterine torsion is rare, especially in a non-gravid uterus.
A post-menopausal woman with known history of uterine leiomyomata presented with sudden, acute pain that was non-amenable to medication. Imaging demonstrated a significant increase in uterine size but was otherwise normal. Primary diagnoses included a degenerative fibroid, leiomyosarcoma, or pelvic thrombosis. Surgical intervention revealed a levo-rotated uterus. Final pathology demonstrated a leiomyosarcoma.
Pelvic organ torsion most often presents as sudden pain that is unrelieved by medication. Diagnosis is sometimes made with imaging and Doppler studies. Surgical intervention is often required. In a patient with a rapidly enlarging fibroid uterus with acute pain, one should consider a uterine torsion.
女性突然出现严重盆腔疼痛时，应促使医生对扭转情况进行评估，最常见的是卵巢扭转。子宫扭转很少见，尤其是在非妊娠子宫中。
一名有子宫平滑肌瘤病史的绝经后女性出现突发剧痛，药物治疗无效。影像学检查显示子宫大小显著增加，但其他方面正常。初步诊断包括变性肌瘤、平滑肌肉瘤或盆腔血栓形成。手术干预发现子宫左旋。最终病理显示为平滑肌肉瘤。
盆腔器官扭转最常表现为突发疼痛，药物治疗无法缓解。有时通过影像学和多普勒检查进行诊断。通常需要手术干预。对于肌瘤迅速增大且伴有急性疼痛的患者，应考虑子宫扭转。
