Acute inversion of a nonpuerperal uterus-a rare case

Abstract

Uterine inversion in a non-pregnant uterus is rare condition usually associated with uterine pathology. Its diagnosis is based on high index of suspicion. Surgery is the main modality of treatment with preferred route being abdominal. A 43-year P5L4A1 previously diagnosed with a uterine fibroid presented in emergency with heavy bleeding P/V. On examination a globular mass 8* 10 cm filling the vagina was seen and uterus was not palpated on P/V and P/R examination. MRI revealed features of inversion secondary to prolapsed fibroid polyp. Diagnosis of uterine inversion was confirmed intraoperatively and abdominal hysterectomy was performed after haultain’s procedure. Postoperative period was uneventful. Diagnosis of uterine inversion requires high index of suspicion and should be looked for and ruled out in a patient previously diagnosed with uterine pathology more so a uterine fibroid. Surgery is the main modality of treatment with preferred route being abdominal. Delineating the ureters via imaging modalities or through preoperative ureteric stenting is prudent to minimize urinary tract injury.