Rudrakumar Senthan, Bhagat Kaivalya, Matthews Lauren Jane, Bhagat Ashish, Malhotra Vivek
West Herts NHS Trust, Hertfordshire, WD18 0HB, United Kingdom.
Luton and Dunstable NHS Trust, Bedfordshire, LU4 0DZ, United Kingdom.
BJR Case Rep. 2025 Apr 4;11(3):uaaf010. doi: 10.1093/bjrcr/uaaf010. eCollection 2025 May.
This case report describes the rare occurrence of a pre-operative radiological diagnosis of uterine torsion in the non-gravid uterus. A 78-year-old female presented with a 5-day history of worsening non-specific gastrointestinal symptoms. Her admission CT study initially reported a large adnexal mass lesion causing obstruction of neighbouring small bowel loops. Management was initiated under the presumption of a complex uterine fibroid causing local small bowel obstruction. Only a secondary radiological review-conducted due to persistent abdominal pain-identified the characteristic "whirlpool" sign of the uterine cavity and prompted the differential of uterine torsion. Contrast-enhanced MRI study further confirmed this suggestion with a lack of uterine contrast uptake and the "X-sign." The patient subsequently had an emergency laparotomy for a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Intra-operative findings and further histological analysis demonstrated a distorted uterine cavity with haemorrhagic infarction, confirming a diagnosis of uterine torsion.
本病例报告描述了非妊娠子宫术前经放射学诊断为子宫扭转的罕见情况。一名78岁女性出现了5天来非特异性胃肠道症状不断加重的病史。她入院时的CT检查最初报告有一个大的附件肿块病变，导致邻近小肠袢梗阻。治疗是在假定为复杂子宫肌瘤导致局部小肠梗阻的情况下开始的。仅因持续腹痛进行的二次放射学检查发现了子宫腔特征性的“漩涡”征，并引发了子宫扭转的鉴别诊断。增强磁共振成像研究通过子宫缺乏造影剂摄取和“X征”进一步证实了这一推测。患者随后接受了急诊剖腹手术，进行了全腹子宫切除术和双侧输卵管卵巢切除术。术中发现及进一步的组织学分析显示子宫腔扭曲并伴有出血性梗死，确诊为子宫扭转。
