CHRONIC UTERINE INVERSION ASSOCIATED WITH FIBROID - A CASE REPORT

Abstract

Introduction: Uterine inversion is a condition in which the uterus turns inside out with prolapse of fundus through the cervix into or outside vagina. Chronic inversion cases are rare. We present a rare case of chronic uterine inversion associated with uterine fibroids. Case Report: A 42 year old female, P L , was admitted with complains of menorrhagia and pain 3 3 lower abdomen for 1 month. Speculum examination revealed a fleshy polyp filling whole of vagina. On per vaginal examination size of mass could not be assessed and cervical lips could not be felt. So, a provisional diagnosis of fibroid polyp was made. Per-operatively inversion of tube and ovaries along with a sessile submucosal fundal fibroid polyp of size 10 x 8 cm was found. A revised diagnosis of chronic uterine inversion with sessile fibroid polyp was made. Patient then underwent Total Abdominal Hysterectomy with Bilateral Salpingo-oophrectomy. Conclusion: Chronic inversion should be kept as a differential diagnosis in a patient with history of irregular bleeding associated with dragging pain of lower abdomen and feeling of a mass coming out of introitus. Pre operatively it should be differentiated from fibroid polyp, uterine prolapse and prolapsed hypertrophied ulcerated cervix.