Chronic Non-Puerperal uterine inversion

Abstract

INTRODUCTION. Inversion of the nonpuerperal
uterus is rare. A high index of
suspicion is required to make a prompt
diagnosis. We describe here a 48-year
old woman who was diagnosed with nonpuerperal
uterine inversion clinically and
ultrasonagraphically and successfully underwent
vaginal hysterectomy in the Institute
of Obstetrics and Gynecology, Egmore,
Chennai. CASE PRESENTATION
A 48 year-old perimenopausal woman
presented to our emergency center with
complaints of a huge mass protruding
from her vagina. At the time of laparoscopy
an inverted uterus with a dimple
containing bilateral round ligaments, infundibulopelvic
ligaments and bladder
was observed.She subsequently underwent
vaginal hysterectomy and bilateral
salpingo-oophorectomy. Pathologic examination
revealed a necrotic submucous
fundal fibroid. CONCLUSION
Chronic nonpuerperal inversion of the
uterus is rare. Most of this condition is
associated with either benign
or malignant tumor arising from the uterine
fundus such as submucous leiomyoma,
sarcoma and endometrial carcinoma.
Cases of complete and total uterine inversion
are usually accompanied by constriction
of the external cervical os that produce
vascular stasis and in neglected cases,
gangrene of the inverted uterus will occur.
Infection should be suspected and appropriate
broad spectrum antibiotics begun
while planning surgery.