PMC6875423_01
Computed tomography (CT) findings of the myomatous uterus. (a) Coronal section of the abdomen one year before the uterine torsion. The myomatous uterus and calcified portion are observed. (b) Coronal section of the abdomen at the time of uterine torsion. The myomatous uterus significantly increased in size, and the calcified lesion was displaced. (c) Three-dimensional reconstruction images of the lower abdomen one year before the uterine torsion. (d) Three-dimensional reconstruction images of the lower abdomen at the time of uterine torsion. The calcified area inside the uterus was largely displaced.
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The mass was consistent with a uterus containing calcified uterine fibroids (Figure 1(a)). The latest CT examination showed that the myomatous uterus significantly increased in size, measuring 27 x 16.5 x 17 cm (Figure 1(b)), and the calcified lesion was largely displaced (Figures 1(c) and 1(d)).
CT findings of the cervix. (a) Axial section of the lower abdomen one year before the uterine torsion. (b) Axial section of the lower abdomen at the time of uterine torsion. The cervix was elongated and moved upward compared with its position one year before (arrow).
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Plain CT images revealed that the uterine cervix was elongated and moved upward compared with its position one year before (Figure 2).
Operative findings of the twisted myomatous uterus. (a) The myomatous uterus was rotated 360 degrees clockwise on the long axis at the level of the isthmus. The uterine surface was discolored, appearing dark red because of the congestion. (b) After releasing the torsion, the uterine color turned red and the lower uterine segment was observed. (c) The resected myomatous uterus and bilateral adnexa. The surface of the uterus was dark red and the cervix was significantly elongated. (d) A cross-section of the uterus revealed the accumulation of clotting blood inside the uterus.
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During emergency surgery, the uterus was found to be rotated 360 degrees clockwise at the level of the isthmus (Figure 3).