title: Torsion of an iatrogenic parasitic fibroid related to power morcellation for specimen retrieval.
abstract: Parasitic fibroids are generally diagnosed incidentally at the time of surgery performed for symptomatic uterine fibroids. Torsion of a parasitic fibroid causing severe acute onset pain is extremely rare. We report a torsed parasitic fibroid in a patient who underwent hysterectomy using power morcellation for specimen retrieval. A 40-year-old patient with a history of laparoscopic supracervical hysterectomy 8 years prior presented with severe abdominal pain. She was diagnosed with degenerating parasitic fibroids on magnetic resonance imaging and was managed conservatively. Surgery was performed 3 days later for persistent pain, and the parasitic fibroid was found to have undergone torsion. Torsed ischemic fibroids can undergo necrosis and gangrene and can potentially cause life-threatening coagulopathy and peritonitis. Awareness of this potential complication will reduce errors in diagnosis and facilitate timely management.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, United States.
authors.forename: Deepa Maheswari
authors.initials: DM
authors.lastname: Narasimhulu
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, United States.
authors.forename: Ellis
authors.initials: E
authors.lastname: Eugene
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, United States.
authors.forename: Saraf
authors.initials: S
authors.lastname: Sumit
keywords: Parasitic fibroid; morcellation; torsion