{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:11:15Z","timestamp":1785161475947,"version":"3.55.0"},"reference-count":11,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,14]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Torsion of a pedunculated uterine leiomyoma is a rare gynaecological emergency. Its nonspecific symptoms can mimic other common conditions, posing significant diagnostic challenges. We present a case that highlights these diagnostic difficulties and the value of a multidisciplinary approach. A woman in her late 20s presented with lower abdominal pain and diarrhoea and was initially misdiagnosed as enteritis during two separate visits. On her third presentation, targeted reassessment and on-site multidisciplinary review of subtle findings on colour Doppler ultrasonography and contrast-enhanced CT supported a diagnosis of torsion of a pedunculated subserosal leiomyoma. Emergency laparoscopic myomectomy was performed with uneventful recovery. A high index of suspicion is crucial when diagnosing a torsed leiomyoma particularly in patients with atypical presentations. A multidisciplinary team approach can be pivotal in overcoming diagnostic challenges and ensuring timely management.<\/jats:p>","DOI":"10.1136\/bcr-2026-272895","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:45Z","timestamp":1785158445000},"page":"e272895","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Challenge in the diagnosis of torsion of a pedunculated uterine leiomyoma"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9315-1611","authenticated-orcid":false,"given":"Duc Truong","family":"Nguyen","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, FV Hospital, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trieu Dat","family":"Vo","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, FV Hospital, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6969-9141","authenticated-orcid":false,"given":"Trong-Vien","family":"Cai","sequence":"additional","affiliation":[{"name":"Medical Office, FV Hospital, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072706203268000_19.7.e272895.1","doi-asserted-by":"crossref","unstructured":"Management of Symptomatic Uterine Leiomyomas: ACOG Practice Bulletin, Number 228. Obstet Gynecol 2021;137. doi:10.1097\/AOG.0000000000004401","DOI":"10.1097\/AOG.0000000000004401"},{"key":"2026072706203268000_19.7.e272895.2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14640"},{"key":"2026072706203268000_19.7.e272895.3","unstructured":"Rezk A , Kahn J , Singh M . Fertility Sparing Management in Uterine Fibroids. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2025. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK574504\/figure\/article-139270.image.f5\/"},{"key":"2026072706203268000_19.7.e272895.4","doi-asserted-by":"crossref","first-page":"102970","DOI":"10.1016\/j.jogc.2025.102970","article-title":"Guideline No. 461: The Management of Uterine Fibroids","volume":"47","author":"Chen","year":"2025","journal-title":"J Obstet Gynaecol Can"},{"key":"2026072706203268000_19.7.e272895.5","doi-asserted-by":"crossref","first-page":"4762","DOI":"10.12998\/wjcc.v12.i21.4762","article-title":"Torsed retroperitoneal leiomyomas: A case report and review of literature","volume":"12","author":"Li","year":"2024","journal-title":"World J Clin Cases"},{"key":"2026072706203268000_19.7.e272895.6","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":"2026072706203268000_19.7.e272895.7","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1016\/j.radcr.2024.12.014","article-title":"Torsion of a large pedunculated subserosal fibroid led to ovarian torsion and ipsilateral hydroureteronephrosis","volume":"20","author":"Oukassem","year":"2025","journal-title":"Radiol Case Rep"},{"key":"2026072706203268000_19.7.e272895.8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.clinimag.2016.09.009","article-title":"Small bowel volvulus due to torsion of pedunculated uterine leiomyoma: CT findings","volume":"41","author":"Guglielmo","year":"2017","journal-title":"Clin Imaging"},{"key":"2026072706203268000_19.7.e272895.9","article-title":"Emergency Surgical Treatment of a Large Pedunculated Subserosal Uterine Leiomyoma With Torsion: A Rare Cause of Acute Abdomen","volume":"16","author":"Thanasa","year":"2024","journal-title":"Cureus"},{"key":"2026072706203268000_19.7.e272895.10","article-title":"Torsion of a Pedunculated Subserosal Leiomyoma: A Rare Cause of Acute Abdominal Pain","volume":"15","author":"Agrawal","year":"2023","journal-title":"Cureus"},{"key":"2026072706203268000_19.7.e272895.11","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000032838","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 (Baltimore)"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:49Z","timestamp":1785158449000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":11,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,27]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2026-272895"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272895","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}