title: Ultrasound diagnosis and comprehensive surgical treatment of complete non-puerperal uterine inversion.
abstract: BACKGROUND
  Ultrasonographic diagnosis of very rare case of complete non-puerperal uterine inversion secondary to a large sub-mucous fibroid.
  
  
  METHODS
  A 50-year-old woman was admitted with heavy vaginal bleeding. Detailed vaginal and abdominal ultrasound, using color Doppler flow, raised the suspicion of complete uterine inversion. The distal ends of the fallopian tubes and part of the ovaries were demonstrated adherent to the uterine fundus. Laparoscopy showed there was no uterus inside the abdomen because of complete uterine inversion. Only a dimple with a constriction ring was found at the site of the uterus. A sub-mucous 6 cm fibroid was attached to the fundus, and vaginal myomectomy was performed to reduce uterine size in order to restore the uterus to its abdominal position. However, the uterus was impacted and only cutting longitudinally the anterior and posterior fornices helped to restore the uterus and facilitate an abdominal hysterectomy. Histological examination of the uterus and fibroid following hysterectomy confirmed their benign nature.
  
  
  CONCLUSIONS
  Ultrasonographic diagnosis of complete uterine inversion is feasible. However, high index of suspicion is necessary.
authors.affiliation: Unit of Urogynecology, Department of Obstetrics and Gynecology, Rabin Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. haimkr@clalit.org.il
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
authors.forename: Zeev
authors.initials: Z
authors.lastname: Efrat
authors.forename: Chen
authors.initials: C
authors.lastname: Goldshmit
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery; D008875:Middle Aged; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery; D019687:Uterine Inversion / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery