{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:33Z","timestamp":1756339533857,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,8,24]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>A woman in her 30s presented to emergency with complaints of acute lower abdominal pain for 3\u2009days, not associated with any menstrual, bowel or urinary symptoms. Examination revealed an abdominopelvic mass corresponding to an 18-week gravid uterus with diffuse tenderness and guarding over her lower abdomen. The patient was a follow-up case of subserosal fibroid uterus, chronic kidney disease stage 4 and rheumatic heart disease on anticoagulants. Fibroid degeneration or torsion was suspected. Ultrasound revealed a large posterior wall subserosal fibroid with free fluid in the pelvis. As findings did not suggest degeneration or pedunculated fibroid, noncontrast CT was done, which showed a similar mass with a pedicle arising from the uterine fundus with free fluid with no other evident cause of acute abdomen. The patient was taken up for emergency laparotomy. Intraoperatively, it was found to be a case of subserosal fibroid with greater omentum adhered to it and twisted around its axis about eight times. This case is being reported to highlight a rare cause of acute abdomen.<\/jats:p>","DOI":"10.1136\/bcr-2023-258651","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T01:00:20Z","timestamp":1725411620000},"page":"e258651","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Torsion of a large subserosal fibroid along with omental torsion adherent to it: a rare cause of acute abdomen"],"prefix":"10.1136","volume":"17","author":[{"given":"Rishu","family":"Goel","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, All India Institute of Medical Sciences, Muzaffarnagar, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2835-1630","authenticated-orcid":false,"given":"Richa","family":"Vatsa","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, All India Institute of Medical Sciences, Noida, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7369-2007","authenticated-orcid":false,"given":"Aparna","family":"Sharma","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidushi","family":"Kulshrestha","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"2025082709032411000_17.9.e258651.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.07.017"},{"key":"2025082709032411000_17.9.e258651.2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318262e320"},{"key":"2025082709032411000_17.9.e258651.3","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.tjog.2018.02.021","article-title":"Torsion of pedunculated subserous uterine leiomyoma: A rare complication of a common disease","volume":"57","author":"Lai","year":"2018","journal-title":"Taiwan J Obstet Gynecol"},{"key":"2025082709032411000_17.9.e258651.4","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000029184","article-title":"Acute abdomen caused by torsion of the omentum: a pediatric case report","volume":"101","author":"Wang","year":"2022","journal-title":"Medicine (Balt)"},{"key":"2025082709032411000_17.9.e258651.5","article-title":"Torsion of the Greater Omentum: A Mimicker of Acute Appendicitis","volume":"15","author":"Yachi","year":"2023","journal-title":"Cureus"},{"key":"2025082709032411000_17.9.e258651.6","article-title":"Pedunculated subserosal leiomyoma with torsion, a rare cause of abdominal pain: A case report","volume":"102","author":"Chang","year":"2023","journal-title":"Medicine (Abingdon)"},{"key":"2025082709032411000_17.9.e258651.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2009.01.012"},{"key":"2025082709032411000_17.9.e258651.8","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1016\/j.radcr.2024.01.031","article-title":"Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review","volume":"19","author":"Yoshida","year":"2024","journal-title":"Radiol Case Rep"},{"key":"2025082709032411000_17.9.e258651.9","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjab287","article-title":"Red degeneration of a large leiomyoma in a non-pregnant woman in pursuit of 17 pregnancies: a case report","volume":"2021","author":"Adwan","year":"2021","journal-title":"J Surg Case Rep"},{"key":"2025082709032411000_17.9.e258651.10","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.radcr.2019.11.001","article-title":"Imaging findings of a torsed pedunculated uterine leiomyoma: A case report","volume":"15","author":"Le","year":"2020","journal-title":"Radiol Case Rep"},{"key":"2025082709032411000_17.9.e258651.11","doi-asserted-by":"crossref","first-page":"760","DOI":"10.3109\/01443615.2015.1004531","article-title":"Torsion of the pedicle of a fibroid parasitized to the greater omentum","volume":"35","author":"Hirayama","year":"2015","journal-title":"J Obstet Gynaecol"},{"key":"2025082709032411000_17.9.e258651.12","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-232797","article-title":"Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain","volume":"14","author":"Stebbings","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082709032411000_17.9.e258651.13","doi-asserted-by":"crossref","first-page":"77","DOI":"10.11152\/mu-1784","article-title":"Torsion of a uterine leiomyoma - a rare cause of hemoperitoneum; 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