Chronic Uterine Inversion in 54 Year Old Woman: Case Report

Abstract

Introduction

Uterine inversion is a disease characterized by the folding of the uterine fundus into the uterine cavity or beyond the cervix. It is a rare complication following parturition. Acute uterine inversion presents immediately following vaginal delivery. Prevalence of acute uterine inversion is 1 in 20,000–50,000 cases. Chronic uterine inversion is a rare disease presentation in post-menopausal women. It is commonly associated with uterine pathology like leiomyoma, leiomyosarcoma, or endometrial polyps. It is very rare without associated factors. In the post-menopausal age group, the diagnosis is confirmed with high index of suspicion and physical examination. Typically, inverted uterine fundus is a leading point of protrusion but it could be the uterine cervix in uterine prolapse.

Case Presentation

A 54 year old woman came to our hospital with the complaint of a painless mass in her vagina of 3 years duration. Three years ago, she encountered a protrusion of mass through her vagina, which gradually grew in size over time. On physical examination, uterine fundus was the leading point of the mass and it protruded 7 cm below the hymenal ring. As a result, she was diagnosed with chronic uterine inversion and underwent an abdominal hysterectomy. She was discharged home improved. We report this case because of an unidentified factor eliciting the uterine inversion, late presentation of the disease and difficulty in surgical treatment.

Conclusion

Chronic uterine inversion is a rare disease presentation especially when there is no associated uterine pathology like leiomyoma. It is seen in a broad range of age groups, from reproductive to postmenopausal. A strong index of suspicion and physical examination are used to reach the diagnosis. Surgical technique should be anticipated to be difficult as it is a rare case, outside the experience of most surgeons.

Keywords:

• chronic uterine inversion
• hysterectomy
• uterine pathology

Ethical Consideration

Institutional approval is not required for case report publication as patient anonymity was respected and informed consent was taken.

Consent for Publication

Written informed consent was obtained for the images and details of the case for publication from the patient.

Disclosure

We declare that there is no conflict of interest in this work.

Additional information

Funding

There was no financial support.