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Case History: 43-year-old female with no significant medical or surgical history presents with acute onset, severe left lower abdominal pain.
Case History: 43-year-old female with no significant medical or surgical history presents with acute onset, severe left lower abdominal pain.
43-year-old female with no significant medical or surgical history presents with acute onset, severe left lower abdominal pain.
Figure 1: Primary concern was for ovarian torsion. TVUS showed a normal sized left ovary, with Doppler and Spectral blood flow, essentially ruling out ovarian torsion. A mass was partially visualized likely a fibroid (arrow).
Figure 2: A contrast-enhanced CT was subsequently performed which showed a large fibroid uterus, in addition to a hypoattenuating and somewhat heterogeneous soft tissue density within the left adnexa measuring 5.6x4.8x6.0 cm.
Figure 3: Intraoperatively, the left adnexal mass was found to be a large pedunculated fibroid, torsed on its pedicle. Given the concern for necrosis & repeat torsion, patient underwent myomectomy.
Patient presented to emergency department with pain that began the night before after she ate some questionable fish. She subsequently had a moderately loose non-bloody bowel movement with no relief.
A limited transvaginal ultrasound was performed but had to be terminated early secondary to patient discomfort. The partial exam demonstrated a normal sized left ovary, with demonstrable Doppler and Spectral blood flow, essentially ruling out ovarian torsion.
Intraoperatively, it was discovered that left adnexal mass was a large pedunculated fibroid, torsed on its pedicle.
Uterine leiomyomas (fibroids) are the most common gynecologic tumors, estimated to be in 20-40% of women of reproductive age.