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A case of uterine torsion concurrent with a ruptured ovarian endometrial cyst

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Abstract

The patient was a 54-year-old female presented with severe abdominal swelling and intermittent pain. On emergent CT, massive ascites with thickened peritoneum and intra-pelvic cystic mass approximately 20 cm in diameter were observed. The cyst wall showed redundant irregular shape. The uterus was enlarged with intramural mass located at its right anterior fundus. MRI showed this pelvic cyst as high intensity on T1-weighted images, so that it was suspected as an endometrial cyst. The operation revealed the rupture of endometrial cyst and the uterine torsion of 180° around the long axis. Retrospectively, the X-shaped configuration of the upper vagina was observed on MRI and both the adnexa, including right ovarian cyst, were connected to the opposite side ovarian vein. Torsion of a non-gravid uterus is rare. In this case, the uterine torsion seemed to be caused by enlarged uterine body and ruptured endometrial cyst. Radiologists should be aware of this potential complication of huge ovarian mass and enlarged uterus and its appearance.

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Funding

This study was not funded by any company.

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Authors and Affiliations

  1. Department of Radiology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan

    Aya Hashimoto, Shinsaku Maeda, Hiroshi Anai & Akio Fukusumi

  2. Department of Radiology, IVR Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan

    Junko Takahama & Kimihiko Kichikawa

  3. Department of Gynecology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan

    Naoya Harada

  4. Department of Pathology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan

    Shunsuke Imai

Authors
  1. Aya Hashimoto
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  2. Junko Takahama
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  3. Naoya Harada
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  4. Shinsaku Maeda
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  5. Hiroshi Anai
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  6. Akio Fukusumi
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  7. Shunsuke Imai
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  8. Kimihiko Kichikawa
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Corresponding author

Correspondence to Aya Hashimoto.

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Conflict of interest

Aya Hashimoto, Junko Takahama, Naoya Harada, Shinsaku Maeda, Hiroshi Anai, Akio Fukusumi, Shunsuke Imai, and Kimihiko Kichikawa declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from the patient included in this study.

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Hashimoto, A., Takahama, J., Harada, N. et al. A case of uterine torsion concurrent with a ruptured ovarian endometrial cyst. Abdom Radiol 41, 1707–1712 (2016). https://doi.org/10.1007/s00261-016-0758-z

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  • DOI: https://doi.org/10.1007/s00261-016-0758-z

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