Asymptomatic Cervical Amputation Caused by Uterine Torsion in a Non-Gravid Woman

非妊娠女性因子宫扭转导致的无症状宫颈切除

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Abstract

Background: Uterine torsion represents a rare condition that may occur during pregnancy or in non-gravid women. This condition is difficult to diagnose, since there are no specific signs besides abdominal pain. Thus, most of the cases are not diagnosed correctly before a surgical procedure and may result in complications and poor outcomes. Methods: We present the first case of uterine torsion of 1080 degrees counterclockwise, with asymptomatic cervical amputation. Results: The intraoperative finding was a uterus that was twisted 1080 degrees around its longitudinal axis, a large fibroid > 15 cm, a large ovarian tumor > 15 cm, and a missing cervix. Upon further inspection, the cervix was found, completely separated from the body of the uterus. After the surgery, the patient remained stable, and her postoperative course was uneventful. She was discharged on the eighth postoperative day. No complications were detected 2 months after the surgery. Conclusions: This specific case is extremely unique, being the only one in searched literature with a 1080° torsion and an amputated cervix. Uterine torsion, especially in postmenopausal women, is a highly rare condition and is difficult to diagnose, with potentially serious outcomes. Any doubts should be assessed as quickly as possible and be dealt with appropriately. If possible, MRI and CT scans could be of great help in differential diagnosis.

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