Torsion of a Pedunculated Subserosal Leiomyoma: A Rare Cause of Acute Abdominal Pain

Abstract

Uterine leiomyomas are benign uterine tumors arising from the smooth muscle cells of the myometrium. Most of them are asymptomatic, and rarely do they present with symptoms like infertility, abdominal distension, and acute abdomen. According to experts, the most common cause of acute abdomen is torsion of a pedunculated subserosal leiomyoma, which is an extremely rare and life-threatening surgical emergency. Here, we discuss a case of torsion of a subserosal leiomyoma where the patient, a 40-year-old female with severe abdominal pain, was misdiagnosed with a twisted ovarian cyst. Ultrasonography and contrast-enhanced computed tomography (CECT) revealed a right-sided ovarian tumor and a twisted subserosal myoma, respectively. Thus, surgical intervention with myomectomy was done.

Emergency Surgical Treatment of a Large Pedunculated Subserosal Uterine Leiomyoma With Torsion: A Rare Cause of Acute Abdomen

“…Acute abdominal pain is not common. However, the sudden onset of acute abdominal pain, as observed in our patient, is typically attributed to complete torsion of the vascular pedicle, followed by hemorrhagic necrosis of the leiomyoma [ 6 ]. Additionally, cystic degeneration of the tumor or infection represents other serious complications of pedunculated subserosal uterine leiomyomas which can cause an acute abdomen [ 7 ].…”