{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T03:10:06Z","timestamp":1785035406783,"version":"3.55.0"},"reference-count":17,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,5]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.<\/jats:p>","DOI":"10.1136\/bcr-2019-232797","type":"journal-article","created":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T12:34:09Z","timestamp":1611750849000},"page":"e232797","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain"],"prefix":"10.1136","volume":"14","author":[{"given":"Clemmie","family":"Stebbings","sequence":"first","affiliation":[{"name":"General Surgery, Lewisham and Greenwich NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Latif","sequence":"additional","affiliation":[{"name":"General Surgery, Lewisham and Greenwich NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janakan","family":"Gnananandan","sequence":"additional","affiliation":[{"name":"General Surgery, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,27]]},"reference":[{"key":"2025082800102693000_14.1.e232797.1","unstructured":"The Royal College of Surgeons of England . Emergency general surgery \u2013 commissioning guide, 2014: 4."},{"key":"2025082800102693000_14.1.e232797.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1703"},{"key":"2025082800102693000_14.1.e232797.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2009.01.012"},{"key":"2025082800102693000_14.1.e232797.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2005.12.004"},{"key":"2025082800102693000_14.1.e232797.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(01)00414-3"},{"key":"2025082800102693000_14.1.e232797.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00534-6"},{"key":"2025082800102693000_14.1.e232797.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.11.011"},{"key":"2025082800102693000_14.1.e232797.8","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.cmrp.2015.10.002","article-title":"Parasitic leiomyoma: a rare complication following laparoscopic myomectomy with review of literature","volume":"5","author":"Grover","year":"2015","journal-title":"Curr Med Res Pract"},{"key":"2025082800102693000_14.1.e232797.9","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1001\/jama.1909.02550190061022","article-title":"Myomata of the uterus","volume":"LIII","author":"Kelly","year":"1909","journal-title":"JAMA"},{"key":"2025082800102693000_14.1.e232797.10","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/0002-9378(53)90380-9","article-title":"Parasitic fibroid","volume":"65","author":"Brody","year":"1953","journal-title":"Am J Obstet Gynecol"},{"key":"2025082800102693000_14.1.e232797.11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/1471-0528.13541","article-title":"Parasitic Myoma after laparoscopic morcellation: a systematic review of the literature","volume":"123","author":"Van der Meulen","year":"2016","journal-title":"BJOG"},{"key":"2025082800102693000_14.1.e232797.12","doi-asserted-by":"publisher","DOI":"10.1148\/rg.287085095"},{"key":"2025082800102693000_14.1.e232797.13","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181b2b09a"},{"key":"2025082800102693000_14.1.e232797.14","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1111\/jog.13011","article-title":"Iatrogenic parasitic leiomyoma and leiomyomatosis peritonealis disseminata following uterine morcellation","volume":"42","author":"Lu","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"key":"2025082800102693000_14.1.e232797.15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ijscr.2017.10.003","article-title":"Parasitic leiomyoma: a case report with literature review","volume":"41","author":"Salih","year":"2017","journal-title":"Int J Surg Case Rep"},{"key":"2025082800102693000_14.1.e232797.16","doi-asserted-by":"crossref","first-page":"rjy164","DOI":"10.1093\/jscr\/rjy164","article-title":"Parasitic leiomyoma of the greater omentum presenting as small bowel obstruction","volume":"2018","author":"Khan","year":"2018","journal-title":"J Surg Case Rep"},{"key":"2025082800102693000_14.1.e232797.17","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.radcr.2018.04.014","article-title":"Parasitic leiomyoma presenting as an inguinal hernia in a postmenopausal woman","volume":"13","author":"Bhargava","year":"2018","journal-title":"Radiol Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232797","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:10:35Z","timestamp":1756365035000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,27]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/bcr-2019-232797"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232797","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}