Query: uterine torsion

title: Uterine torsion in the second trimester of pregnancy.
abstract: Torsion of the pregnant uterus is a very rare complication. It may occur at any gestational age. The treatment depends on the intensity of symptoms, intraoperative ischemic signs and the gestational age.  We present a case report of 33 year old primipara accidentally diagnosed with uterine torsion during appedectomy.  The patient underwent surgery at 19th week of gestation due to severe pain in the right iliac fossa and increased levels of inflammation markers. Intraoperatively acute appendicitis and levorotation of the uterus by about 100 degrees were found. As the signs of ischemia were absent, the uterus was returned into its normal position. Intraoperative and postoperative period was uncomplicated. Close outpatient monitoring was introduced and the pregnancy continued without further complications. The patient underwent cesarean section at 36 weeks of pregnancy due to early leakage of amniotic fluid and failure to progress during first stage of labor.  Uterine torsion may present with non specific symptoms or be asymptomatic. Urgent laparotomy and rotation of the uterus into its normal anatomical position gives chance for normal course of pregnancy. Subsequent close outpatient care is obligatory to asses viability of the fetus and early detection of possible pregnancy complications.

title: Uterine torsion with necrosis of bilateral adnexa in a postmenopausal woman
abstract: Uterine torsion is an uncommon entity that is defined as a rotation of greater than 45deg around the longitudinal axis of the uterus. Although cases of uterine torsion among pregnant patients have been mentioned in the literature, torsion of a non gravid uterus is a rare occurrence. A 73 year old nulliparous woman with a known fibroid uterus underwent a total abdominal hysterectomy and bilateral salpingo oophorectomy with frozen section of a 17 18 cm pelvic mass seen on CT imaging. The source of the pelvic mass was unclear on imaging, and benign and malignant possibilities were discussed. During the procedure, necrosis of the uterine fundus and bilateral adnexa were seen due to the fundus being torsed with the uterine fibroid being the pivot point. Uterine torsion, though rare, can be the cause of acute pelvic pain in a postmenopausal woman.

title: A Rare Case of Uterine Torsion With Juvenile Granulosa Cell Tumor in the Pediatric Patient.
abstract: Juvenile granulosa cell tumors of the ovary are rare sex cord stromal ovarian tumors that are typically diagnosed during the first 2 decades of life. Most patients present with precocious puberty in the early stages of disease. We present a rare case of asymptomatic uterine torsion from a 15 cm juvenile granulosa cell tumors in a 5 year old girl with elevated inhibin B, breast development, vaginal bleeding, and a palpable right sided abdominal mass.

title: Transrectal ultrasonography and blood lactate measurement: a combined diagnostic approach for severe uterine torsion in dairy cattle
abstract: In this study, we aimed to elucidate the utility of transrectal ultrasonography (TRUS) and blood lactate concentration (bLac) measurement to diagnose cows with severe uterine torsion. We investigated the association of TRUS and bLac measurement with macroscopic findings on laparotomy for severe uterine torsion in nine cows. We found that an increased ultrasonographic cross sectional thickness (15 25 mm) and multiple hypoechogenic areas corresponded to macroscopic vascular compromise in the uterus on laparotomy. In addition, bLac was elevated =5.0 mmol/l) in cows showing uterine necrosis on laparotomy. A combined diagnostic approach with TRUS and bLac measurement enables assessment of the uterine vascular status and has utility for selecting the treatment option (including laparotomy) and predicting the outcomes.

title: Management of Uterine Torsion in a Doe
abstract: A pregnant multiparous doe with history of intermittent straining since last night was presented. Clinical examination with the help of vaginoscope and abdominal radiograph revealed post cervical uterine torsion. Detorsion of right sided post cervical torsion was corrected with modified Schaffer's method. One live male kid was delivered per vaginally by traction method.

title: Surgical management of uterine torsion through ventral celiotomy in eleven mares
abstract: This article describes the surgical management of uterine torsion by midline celiotomy for cesarean section in 11 mares presented with signs of colic at a teaching veterinary hospital. The mares were either in full term of gestation (n 6) or in advanced stage of pregnancy (n 5) Majority of the mares (44.5% were in fourth parity. 78% cases of uterine torsion were post cervical and clockwise and (22% cases were post cervical and anticlockwise. For surgical intervention, mares were anesthetized using a combination of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg) intravenously and maintained on isoflurane inhalation anesthesia. Midline celiotomy was performed, and foals were delivered by cesarean section. Before closing the abdominal wound, the uterus was detorted manually and confirmed per vaginally for its normal position. After long term follow up, the study reported 90.0% (10/11) survival rate out of which, seven were bred successfully.

title: Dystocia due to pre cervical uterine torsion in a Nellore brown ewe
abstract: Nellore brown sheep in its third parity was presented with the complaint of completed full term gestation but no showing any signs of lambing since two days. Bimanul abdominal palpation revealed presence of fetus. On per vaginal examination, right side pre cervical uterine torsion was observed. All the vital parameters were within the physiological range. Correction of uterine torsion was done using modified Schaffer's method. Following correction, one dead male lamb relieved through mutational operations. Ewe had an uneventful recovery after treatment.

title: A retrospected studies on the incidence, type of uterine torsion in surti buffaloes (Bubalus bubalis)
abstract: The incidence of uterine torsion in buffaloes was calculated by retrospective analysis of the records of dystocia in buffaloes presented in 2 years and 6 months i.e. Feb, 2015 to July, 2017. Out of the 78 total cases of dystocia in buffaloes 66 (84.62% were of maternal and 12 (15.38% were of fetal origin. Uterine torsion was a major cause (70.51% of the total dystocia cases in buffaloes. Torsion affected buffaloes were grouped under three categories viz. 3 6 years: 19/55 (34.54% 6 9 years: 22/55 (40.00% and 9 12 years: 14/55 (25.45% The age of the animals had no affect on incidence of uterine torsion. In the present study, 96.36% (53/55) buffaloes suffered from right side uterine torsion. Post cervical location of uterine torsion was observed in 96.36% (53/55) cases whereas only 3.63% (2/55) cases of precervical location of uterine torsion were reported. Only one case was reported pre cervical with left sided torsion. In the current study, 27 of the 55 buffaloes (49.09% had suffered from 90deg to 180deg torsion. Similarly the same numbers of animals viz. 27 out of the 55 buffaloes (49.09% were reported with torsion of 180deg to 360deg and only a single case (1.81% was affected with a highest degree of viz. 360deg of uterine torsion.

title: Treatment of simultaneous occurrence of uterine torsion and incomplete cervical dilatation in surti buffalo
abstract: Rotation of gravid uterus along its own axis defined as uterine torsion which is very common in the buffalo during the last trimester of pregnancy. Here, a case of 5 year old buffalo which was in 2 parity affected by uterine torsion and incomplete cervical dilatation simultaneously discussed. Primarily torsion was relieved by Modified Schaeffer's Method and then treatment for incomplete cervical dilatation followed. Response to treatment took 24 hours. At the end cervix was dilated sufficient so that dead fetus removed by traction. Animal recovered successfully within a short period of time.

title: Incidence of Uterine Torsion and Related Factors in Buffaloes of Amul Milk Shed Area
abstract: A study was carried out to find out the retrospective incidence of uterine torsion in buffaloes among obstetrical cases in Amul milk shed area and factors influencing it. Data on 1,13,772 obstetrical cases attended from January 2017 to June 2018 by Amul Veterinarians were collected. Moreover, 50 buffaloes suffering from uterine torsion were taken up during July December, 2018 to know the side, site, degree of uterine torsion, parity as well as sex and viability of the calf and the dam after detorsion/Caesarean section in the same area. In the retrospective study, a total of 2000 cases of uterine torsion were recorded among total 1,13,772 bovine obstetrical cases, which encompassed 1.76% Of the 2000 cases, 92.20 (1844) percent torsions were found in buffaloes only. Among 57,111 obstetrical cases attended in buffaloes, the incidence of uterine torsion was 3.23% Moreover, the region/center wise incidence of torsion cases varied from 1.30 19.36% The highest incidence of uterine torsion was found in Anand region (19.36 followed by Kathlal (11.23 and Mahemdabad (10.14 regions, while the lowest incidence was in Virpur (2.06% Petlad (1.46% and Piplata (1.30% It was concluded that buffaloes mostly experience right side (100% post cervical (82% uterine torsion of 270 360deg (66% at full term of gestation (70%)with lower survivability of the calves (30% however, the survival rate of the dams post treatment was 90%