Chronic non-puerperal uterine inversion in the absence of risk factors: a rare case report

Abstract

Non puerperal chronic uterine inversion is a rare entity; representing 1/6^th of all uterine inversions. Usually precipitated by risk factors like fibroid uterus, endometrial polyp, endometrial malignancies. We present a case of 25 year old P2L2 with irregular vaginal bleeding and pain abdomen, with severe anemia. On per abdomen examination no abnormality detected, per speculum revealed a red friable mass 5*5cms protruding through vagina and per vaginal examination same findings confirmed. A diagnosis of fibroid polyp made initially and planned for polypectomy after correction of anemia. Under spinal aneasthesia diagnosis was changed to uterine inversion. Exploratory laparotomy done, which revealed characteristic flower pot appearance. Inversion was corrected by Haultens method, where in posteriorly incision was given to cut the tight cervical ring, and uterus was repositioned back to normal anatomic positon. Bilateral tubal sterilization was done as per patients request. Post operative period was uneventful and she was discharged in stable condition. Thus chronic non puerperal uterine inversion can be difficult to diagnose in the absence of risk factors.