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A Rare Case of Complete Uterine Torsion in a Postmenopausal Woman

We present a rare case of uterine torsion caused by an 18-cm subserosal myoma weighing 3.9 kg in a postmenopausal lady in a tertiary center. A 52-year-old postmenopausal lady presented with abdominal pain and no bowel movements of 3 days duration. Multiplanar computed tomography (CT) of abdomen and pelvis showed uterine torsion, while initial pelvis ultrasound was unremarkable. Patient underwent laparotomy and was found to have torsion of the uterus at the level of the isthmus with a large subserosal myoma. She underwent total hysterectomy and bilateral salpingo-oophorectomy. Post-operatively, patient recovered well. Subserosal myoma causing uterine torsion is extremely uncommon, but in a known case of large subserosal myoma in a postmenopausal lady, high index of suspicion is needed when they present with acute abdominal pain. However, prompt identification with advanced radiological imaging is important to minimize associated morbidity and mortality. J Med Cases. 2019;10(6):164-167 doi: https://doi.org/10.14740/jmc3314