NON-PUERPERAL UTERINE INVERSION SECONDARY TO PROLAPSED ADENOMYOMA

Non-puerperal uterine inversion is a rare, challenging and life threatening condition with only limited case reports published in literature. The most common cause are leioyomas followed by uterine sarcomas. Early diagnosis is imperative to prevent morbidities. Multidisciplinary team is required to maximize surgical management either vaginal or abdominal approach. We present a case of a 67-year old multigravid who presented with vaginal bleeding and prolapsed uterine mass. The initial consideration was a malignancy and surgical intervention was done by exploratory laparotomy, peritoneal fluid cytology, bilateral internal iliac artery ligation, vaginal resection of the uterine mass, uterine repositioning, total hysterectomy with bilateral salpingoophorectomy and surgical staging. Final histopathologic showed prolapsed adenomyoma, in torsion. The patient had an unremarkable post operative course and she followed up at the outpatient services of Obstetrics and Gynaecology (OB-GYN) clinic for post operative wound care. Due to its rarity, we present different presentation and causes of non-puerperal uterine inversion and management options when one encounters such case.