CTで術前診断し得たまれな漿膜下子宮筋腫茎捻転の1例

A case of acute torsion of uterine subserosal leiomyoma

婦人科腫瘍性疾患の中で子宮筋腫は最も高頻度にみられるものであり，30歳以上の女性の20～30％に認められる^1）。しかし，漿膜下子宮筋腫茎捻転は非常にまれな疾患であり，子宮筋腫手術症例の0.1～0.3％といわれている^2）。漿膜下子宮筋腫茎捻転が起こると激しい腹痛が生じ，壊死を契機に腹膜炎へと至り，治療介入が遅れると致死的となり得る。今回，緊急腹部CTで漿膜下子宮筋腫茎捻転と診断し，速やかな治療介入を得ることができた症例を経験したので，若干の文献的考察を加えて報告する。

A woman in her 50s who had a medical history of uterine leiomyoma presented with abdominal pain for 3 days. Abdominal CT showed multiple uterine leiomyomas and a poorly enhanced mass on the cephalic side of the uterine. Based on CT features of acute torsion of uterine leiomyoma such as twisted vascular pedicle and thin rim enhancement, we were able to make a correct diagnosis of acute torsion of uterine leiomyoma. This disease can be lethal by delay in treatment. When a patient with uterine leiomyoma presents abdominal pain, it is important to consider the possibility of acute torsion.