Nonpuerperal acute uterine inversion in a nullipara

Abstract

Nonpuerperal acute inversion of the uterus is a rare condition that occurs as a complication of intrauterine tumors, especially large submucosal leiomyomas. This inversion is so rare that many gynecologists may not encounter it in their entire professional careers. The condition causes severe pain, vaginal bleeding, and shock. Case: A-28 year old nullipara had a large submucosal fibroid tumor. She presented with vaginal bleeding, lower abdominal pain, and a mass protruding from her vagina of 8 hours duration. This case was initially managed by vaginal myomectomy; then, the patient's uterus was repositioned manually. Results: The patient's postoperative period was uneventful. Histopathology testing of the tumor revealed that it was a leiomyoma, weighing ∼150 g. She recovered fully and resumed her normal activity after 2 weeks. Conclusions: Acute nonpuerperal inversion of the uterus is uncommon and is usually associated with a fundal submucousal myoma extrusion. A high index of suspicion is imperative to limit morbidity and enhance prompt management.