ABSTRACT
Introducción. El tratamiento quirúrgico adecuado para las pacientes pediátricas con lesiones ováricas es heterogéneo, y en las niñas es conveniente conservar los ovarios. El objetivo de este estudio es analizar los hallazgos relacionados con un grupo de pacientes a las que se operó por lesiones ováricas. Pacientes y métodos. Un estudio retrospectivo realizado durante 13 años con 56 pacientes menores de 17 años. Estas pacientes se dividieron en 3 grupos según el diagnóstico de patología ovárica: 25 tenían lesiones funcionales (quistes y torsión), 18 tenían lesiones ováricas epiteliales y 13 tenían tumores germinales. Se comparó a estos tres grupos en términos de menarquia, torsión, edad, duración, tamaño, dolor, tumor, vómitos, menstruación irregular, ubicación y tipo de operación. Resultados. Enestosgrupos,fueronmásfrecuentes los quistes foliculares, los cistoadenomas serosos y los teratomas. La media de edad de las pacientes fue de 12,18 ± 4,84 años. Los síntomas y signos más frecuentes fueron dolor (85,7%) e hinchazón (37,5%) en la región abdominopélvica. Se observó torsión en 21 pacientes (37,5%); la media del tamaño del tumor fue de 10,46 ± 6,55 cm. Se realizó una salpingoovariectomía (SO, por sus siglas en inglés) en 38 pacientes y una resección del quiste (CE, por sus siglas en inglés) en 18 pacientes. Se observaron más casos de torsión en las pacientes premenárquicas que en las menárquicas y en el grupo de lesiones funcionales. Se realizaron más resecciones quirúrgicas en el grupo de lesiones funcionales, y más SO en los grupos de lesiones epiteliales y tumores germinales. Conclusión. Se considera que la torsión y las patologías ováricas funcionales son frecuentes en la edad premenstrual, y las lesiones malignas son muy raras en todos los grupos etarios, por lo que se recomienda preservar la fertilidad en la cirugía.
Introduction. The appropraite surgical treatment to pediatric patients with ovarian lesions are heterogeneous and ovarian preservation is desirable in children. The aim of this study is to the discuss findings related to a set of patients who were operated on for ovarian lesions. Patients and methods. A retrospective study carried out in 13 years on 56 patients under the age of 17. These patients were divided into 3 groups according to ovarian pathologic diagnosis: 25 with functional (cyts and torsion), 18 with epithelial ovarian lesions and 13 with germ cell tumours. These three groups were compared in terms of menarche, torsion, age, duration, size, pain, mass, vomiting, irregular menstruation, location and operation type. Results. Follicle cysts, serous cyst adenomas and teratomas were the most common in these groups. The mean age of the patients was 12.18+4.84 years. The most common symptoms and signs were abdominal-pelvic pain (85.7%) and swelling(37.5%). Torsion was seen in 21 patients (37.5%), mean mass size was found to be 10.46+6.55 cm. A salpingo-oophorectomy (SO) was performed in 38 patients and cyst excision (CE) was performed in 18 patients. In premenarcheal cases, torsion was seen more in menarcheal cases and in the functional lesion group. CE was performed more often in the functional and t SO was performed often in the epithelial and germ cells groups. Conclusion. Torsion and functional ovarian pathologies are thought to be common in premenstrual ages and malign lesions are very rare in all age groups so we recommend ovarian protective surgery should be preferred.
Subject(s)
Humans , Female , Infant , Child, Preschool , Child , Adolescent , Ovarian Cysts/surgery , Ovarian Diseases/surgery , Ovarian Neoplasms/surgery , Neoplasms, Germ Cell and Embryonal/surgery , Organ Preservation/methods , Ovarian Cysts/diagnosis , Ovarian Diseases/diagnosis , Ovarian Neoplasms/diagnosis , Torsion Abnormality/surgery , Torsion Abnormality/diagnosis , Abdominal Pain/etiology , Retrospective Studies , Age Factors , Pelvic Pain/etiology , Neoplasms, Germ Cell and Embryonal/diagnosis , Salpingo-oophorectomy/methodsABSTRACT
Resumen Antecedentes: El vólvulo de la vesícula biliar se produce por el giro de la vesícula sobre su mesenterio a lo largo del eje del conducto y arteria císticos, con afectación de la irrigación vascular de forma completa o incompleta, pudiendo existir ciertas características anatómicas predisponentes. Caso clínico: Masculino de 87 años quien cursó con abdomen agudo; sospechando cuadro de piocolecisto, se realizó exploración quirúrgica encontrando como hallazgos triple torsión vesicular y múltiples litos color oscuro; se realizó colecistectomia abierta, cursando con una evolución satisfactoria. Discusión: Se trata de una entidad infrecuente que puede simular una colecistitis aguda; generalmente tiene buen pronóstico cuando el diagnóstico se realiza a tiempo. El tratamiento de elección es la colecistectomía laparoscópica.
Abstract Background: The gallbladder volvulus is produced by the rotation of the gallbladder over its mesentery along the axis of the cystic duct and artery, with involvement of vascular irrigation in a complete or incomplete way, and there may be certain predisposing anatomical characteristics. Clinical case: Male patient of 87 years who attended with acute abdomen, suspecting pyogenic cholecystitis, performs surgical exploration finding as vesicular triple twist, multiple stones dark. Open cholecystectomy is performed, following a satisfactory evolution. Discussion: It is an uncommon entity that can simulate acute cholecystitis, usually has a good prognosis, when the diagnosis is made on time. The treatment of choice is laparoscopic cholecystectomy.
Subject(s)
Humans , Male , Aged, 80 and over , Torsion Abnormality/surgery , Torsion Abnormality/complications , Gallbladder Diseases/surgery , Gallbladder Diseases/complications , Torsion Abnormality/diagnosis , Cholecystectomy/methods , Cholecystitis/diagnosis , Laparoscopy , Gallbladder Diseases/diagnosis , Abdomen, Acute/etiologyABSTRACT
OBJECTIVE: To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion. MATERIALS AND METHODS: This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance. RESULTS: Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively). CONCLUSION: Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Middle Aged , Young Adult , Acute Pain/diagnosis , Adnexa Uteri/pathology , Adnexal Diseases/diagnostic imaging , Area Under Curve , Pelvis/diagnostic imaging , ROC Curve , Retrospective Studies , Tomography, X-Ray Computed/methods , Torsion Abnormality/diagnosisABSTRACT
Purpose: Evaluate the magnitude of cyclotorsion during cataract surgery in patients with indication for intraocular toric lenses comparing the results after peribulbar and after topical anesthesia. Methods: This prospective study comprised 112 eyes that underwent cataract surgery with implantation of toric intraocular lens by topical anesthesia or peribulbar block. We estimated how many degrees of cyclotorsion occurred after topical anesthesia and peribulbar block with the patient in supine position. A tag was performed in the position of 180 degrees of the right eye and zero degrees of the left eye, with the patient seated. Afterwards, it was requested a change to the supine position and then a new dial in 180 and zero degrees respectively from right and left eye were made. Results: The current study demonstrated that patients submitted to cataract surgery with implantation of toriclens under local anesthesia showed approximately 6.89 degrees of incyclotorsion (82 eyes) and 6.93 degrees of excyclotorsion (38 eyes) and a mean of cyclotorsion of 6.91 degrees. Patients undergoing peribulbar block showed 5.68 degrees of incyclotorsion (73 eyes) and 4.81 degrees of excyclotorsion (47 eyes) and a mean of cyclotorsion of 4.92 degrees. Conclusion: Through the study we can see that the movement of incyclotorsion in patients undergoing peribulbar anesthesia was lower when compared to topical anesthesia. This is relevant since the greater the incyclotorsion, the lower the predictability of the surgery and the lower the chance of obtaining excellent results in the final refractometric. .
Objetivo: Avaliar a magnitude da ciclotorção durante a cirurgia de catarata em pacientes com indicação de lentes intraoculares tóricas comparando os resultados após o bloqueio peribulbar e após a anestesia tópica. Métodos: Esse estudo prospectivo compreende 112 olhos que foram submetidos à cirurgia de catarata com implante de lente intraocular tórica por meio de anestesia tópica ou bloqueio peribulbar. Foram estimados quantos graus de ciclotorção ocorreu após a anestesia tópica e após o bloqueio peribulbar, com o paciente em posição supina.Foi realizada uma marcação na posição de 180 graus do olho direito e zero grau do olho esquerdo, com o paciente sentado, em seguida,houve uma mudançade posição para decúbito dorsal, sendo realizadas novas marcações em 180 e zero graus dos olhos direito e esquerdo, respectivamente. Resultados: O presente estudo demonstrou que pacientes submetidos à facoemulsificação com implante de lente tórica com anestesia tópica apresentaram aproximadamente 6.89 graus de inciclotorção (82 olhos) e 6,93 graus de exciclotorção (38 olhos) com uma média de ciclotorção de 6.91 graus. Já os pacientes submetidos à anestesia peribulbar apresentaram 5.68 graus de inciclotorção(73 olhos) e 4,81 graus de exciclotorção (47 olhos) com uma média de ciclotorção de 4,92. Conclusão: Através do estudo podemos observar que o movimento de inciclotorção em pacientes submetidos à anestesia peribulbar foi menor quando comparado ao da anestesia tópica. Isso se torna relevante uma vez que, quanto maior for a inciclotorção, menor a previsibilidade da cirurgia e menor a chance de obtenção de excelência nos resultados refratométricos finais. .
Subject(s)
Humans , Optical Rotation , Posture , Torsion Abnormality/diagnosis , Cataract Extraction , Supine Position , Visual Acuity , Prospective Studies , Administration, Topical , Cornea/physiology , Lens Implantation, Intraocular , Eye Movements , Patient Positioning , Intraoperative Complications , Anesthesia, Local , Nerve BlockABSTRACT
We report a 40 years old female consulting in the emergency room for abdominal pain and a mass in the left lower quadrant. An abdominal CAT sean showed an omental torsion. The patient was operated, excising the involved omentum. The postoperative period was uneventful and the patient was discharged three days after admission.
El objetivo de este trabajo es presentar el caso clínico de una paciente con torsión de epiplón manejado en nuestra institución. Se trata de una paciente de sexo femenino de 40 años de edad, que se presenta al servicio de urgencias por clínica de dolor abdominal de una semana de evolución asociado a masa abdominal en flanco izquierdo, en quien se realiza tomografía que revela cambios compatibles con torsión de epiplón por lo cual es llevada a cirugía realizándose resección de todo el omento.
Subject(s)
Humans , Female , Adult , Torsion Abnormality/surgery , Torsion Abnormality/diagnosis , Peritoneal Diseases/surgery , Peritoneal Diseases/diagnosis , Omentum/pathology , Abdomen, Acute/etiology , Torsion Abnormality/complications , Peritoneal Diseases/complicationsABSTRACT
A torção peniana congenital, constituindo-se em uma anomalia isolada, é uma relevante malformação, que ultimamente tem aumentado a frequência em publicações. Caracteriza-se pela rotação da rafe mediana em espiral e quase sempre segue a direção para a esquerda. Se a rotação é moderada, quando tem menos de 90 graus de rotação, não apresenta sintomas nem dificulta a ereção. Independente do grau de rotação e da idade, e dentro do contexto psicossocial, a correção cirúrgica está indicada. Quando estiver associada à fimose e outras afecções, o tratamento ideal é desfazer a rotação no ato da circuncisão. Far-se-á a retração da pele até a base do órgão, a seguir desfazendo a rotação e finalizando igualmente a circuncisão.
Subject(s)
Humans , Male , Torsion Abnormality/diagnosis , Torsion Abnormality/therapy , Penile Diseases/surgeryABSTRACT
Femoro-acetabular impingement is an anatomical disturbance of the hip, caused by a deformity of the acetabulum, femur or both that causes an abnormal contact between both structures during certain movements. Its prevalence is 10 to 15 percent and causes chronic inguinal pain. It can be confused with several other causes of inguinal pain such as hernias, facet syndromes, a renal colic, etc. Patients with this condition are usually young individuals with inguinal pain that may appear after a minor trauma. During examination, pain may be elicited by infernal rotation and abduction movements of hip, flexed in 90°. Plain hip X ray is the most commonly used diagnostic method. Non-steroidal anti-inflammatory drugs and physical therapy can be used to alleviate pain, but the definitive treatment is surgical.
Subject(s)
Female , Humans , Male , Young Adult , Acetabulum , Femur , Pain/etiology , Torsion Abnormality/complications , Chronic Disease , Constriction, Pathologic/complications , Constriction, Pathologic/diagnosis , Diagnosis, Differential , Groin , Torsion Abnormality/diagnosis , Young AdultABSTRACT
Primary or idiopathic torsion of the greater omentum, without preexistent abdominal disease, in an uncommon cause of acute abdomen. On account of its raraness and absence of specific symptomatology, the diagnosis usually is performed at laparoscopy. This condition can be mistaken for appendicitis and in women the alternative diagnosis is usually a twisted ovarian cyst. The twisted omentum may become gangrenous and give rise to peritonitis. We report a patient with an acute abdomen with HIV infection with primary torsion fo the greater omentum. This torsion with primary infarction of the greater omentum is an infrequent cause of acute abdomen as much as in immunocompetent patients the same as in HIV positives. The elective treatment is the surgical removal.
Subject(s)
Humans , Male , Adult , Torsion Abnormality/diagnosis , Torsion Abnormality/pathology , Abdominal Pain/etiology , Omentum/pathology , HIV , Laparotomy , Lipodystrophy, Familial Partial/pathologySubject(s)
Humans , Female , Torsion Abnormality/diagnosis , Uterus , Leiomyoma , Uterine Neoplasms , Broad Ligament , Magnetic Resonance ImagingABSTRACT
Background: Feet rotation during walking is a frequent worrying motive. Most of the time, it corresponds to physiological conditions and variations within the normal range. Objective: Evaluate the factors involved in walking on healthy children, according to physical examination performed by Staheli method and its correlation with symptoms. Method: Evaluation of 610 healthy children at Santiago - Chile; 10 cases were excluded due to previous orthopedic pathology. A questionnaire was applied, which included perinatal factors, previous pathologies and lower limb related symptoms. An anthropometric evaluation and specific physical examination of lower limb rotations was also performed. The data was statistically analysed. Results: 58 percent of cases presented neutral walking, 23 percent of children had convergent walking and 19 percent presented divergent walking. There is a direct relationship between age and type of walking, being convergent walking most frequent at lower ages, due to bigger hip anteversion and greater internal tibial torsion. The plane foot and metatarsus adductus do not influence lower limb rotation. Obese children presented divergent walking most frequently. There are no significant differences in terms of lower limb pain and walking alterations. Conclusions: Walking has a known natural history, with a wide normality range and most of the time, it solves spontaneously without the need of specific therapy.
Introducción: La rotación de los pies al caminar es un motivo de preocupación y consulta frecuente. La gran mayoría de las veces corresponde a condiciones fisiológicas y variaciones dentro de lo normal, por lo que deben ser tratadas como tales. Objetivo: Evaluar tipo de marcha y factores involucrados en niños sanos, según el examen físico por método de Staheli y correlacionarlo con la presencia de síntomatología. Pacientes y Método: Evaluación de 610 niños sanos en Santiago de Chile. Se excluyeron 10 niños por patología ortopédica previa. Se aplicó encuesta que incluyó factores perinatales, patologías previas y síntomas de extremidades inferiores. Se realizó una evaluación antropométrica, examen físico general y dirigido a las rotaciones de las extremidades inferiores. Los datos se analizaron estadísticamente. Resultados: La mayoría presentó marcha en neutro: 58 por ciento, seguido por la marcha convergente: 23 por ciento, y por marcha divergente en 19 por ciento. Se encontró una directa relación entre la edad y el tipo de marcha, siendo a menor edad más frecuente la marcha convergente, lo que tiene relación con la mayor antetorsión de las caderas y la mayor torsión tibial interna. El pie plano o metatarso varo no influyen en el tipo de marcha. Los pacientes obesos presentaron mayor prevalencia de marcha divergente. No hubo diferencias significativas respecto al dolor en extremidades inferiores ni alteraciones en la marcha. Se concluye que, en concordancia con la literatura, la marcha tiene una historia natural conocida, que el rango de normalidad es amplio, que la mayoría se resuelve espontáneamente y no requiere de tratamiento específico.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Walking/physiology , Gait/physiology , Rotation , Age and Sex Distribution , Anthropometry , Torsion Abnormality/diagnosis , Chile/epidemiology , Lower Extremity/physiology , Physical Examination , Flatfoot/diagnosis , Risk FactorsSubject(s)
Humans , Male , Middle Aged , Kidney Failure, Chronic/etiology , Kidney Transplantation/adverse effects , Kidney Tubular Necrosis, Acute/etiology , Lymphocele/etiology , Kidney Tubular Necrosis, Acute/diagnosis , Lymphocele/diagnosis , Magnetic Resonance Angiography , Pancreas Transplantation/methods , Renal Artery , Torsion Abnormality/complications , Torsion Abnormality/diagnosisABSTRACT
A young male presented with acute abdominal pain of 4 days. Treated as appendicular mass, which did not responds to conservative management. Ultra Sound scan and CT abdomen failed to give a definite diagnosis of the tender fixed mass in lower abdomen. Laparotomy proved the mass to be an engorged large spleen twisted on its long vascular pedicle, the ischemic spleen adherent to bowel loops and posterior peritoneum. Splenectomy performed. Postoperative reactionary hemorrhage required re-exploration and clearance of clots. Patient had uneventful recovery
Subject(s)
Humans , Male , Torsion Abnormality/diagnosis , Abdomen, Acute , Abdominal Pain , Wandering Spleen/diagnosisABSTRACT
Isolated torsion of the fallopian tubes is a rare condition. Although, it can occur at all ages, it is mostly observed during reproductive ages. Early diagnosis and urgent management of the condition is crucial to preserving the tube. A 12-year-old premenarcheal girl presented with a sudden, severe right-sided lower abdominal pain. The pain had begun 24 hours earlier. The girl had nausea and vomiting. Abdominal examination revealed tenderness in the right lower quadrant with no palpable mass. Pelvic ultrasound showed a right adnexal mass measuring 65X35 mm and containing dense and cystic tissues with simple appearance. At laparotomy, an isolated twist of the right fallopian tube with necrosis was found, leaving no choice other than salpingectomy. Menstruation began one week following surgery. Isolated torsion of the fallopian tube should be considered in the differential diagnosis of acute abdominopelvic pain in premenarcheal adolescent girls. Prompt surgical intervention is necessary to preserve the fallopian tube
Subject(s)
Humans , Female , Torsion Abnormality/diagnosis , Torsion Abnormality/surgery , Diagnosis, Differential , Abdominal Pain/etiology , Abdominal Pain/diagnosis , UltrasonographyABSTRACT
Isolated torsion of the fallopian tube is an uncommon event. Its incidence is estimated at 1 per 1 500 000 among women in genital activity. We report a case of isolated torsion of fallopian tube caused by a paraovarian cyst in a 24 years old patient presenting an acute pelvic pain, nausea and vomiting. The clinical examination revealed a mass of 7cm. Pelvic ultrasound showed an adnexal mass. The laparoscopy performed revealed a severe torsion of the left fallopian tube caused by a paraovarian cyst. Based on this experience as well as on other similar reported cases, characteristics of isolated torsion of the Fallopian tubes are discussed. This pathology should be considered in the differential diagnosis of acute pelvic pain in the female patient. Prompt surgical intervention may allow preservation of the tube
Subject(s)
Humans , Female , Torsion Abnormality/diagnosis , Fallopian Tube Diseases/surgery , Disease Management , Laparoscopy , Ovarian Cysts , Pelvic Pain , Nausea , Vomiting , Fallopian TubesABSTRACT
Torsion of greater omentum is a rare cause of acute abdomen. However, it should be included in the differential diagnoses in addition to acute cholecystitis, acute appendicitis, cecal diverticulitis, and other variable causes of acute abdomen. Diagnosis is usually made at laparotomy for suspected appendicitis. In some cases, computed tomography demonstrates a successful preoperative detection of omental torsion. We report a case of surgically and pathologically proven torsion with subsequent infarction of greater omentum presented as an acute abdominal pain.
Subject(s)
Adult , Humans , Male , Abdomen, Acute/diagnosis , Diagnosis, Differential , Infarction/diagnosis , Omentum/blood supply , Peritoneal Diseases/diagnosis , Tomography, X-Ray Computed , Torsion Abnormality/diagnosisABSTRACT
The extravasation of chyle into the peritoneal space usually does not accompany an abrupt onset of abdominal pain with symptoms and signs of peritonitis. The rarity of this condition fails to reach preoperative diagnosis prior to laparotomy. Here, we introduce a case of chylous ascites that presented with acute abdominal pain mimicking peritonitis caused by ovarian torsion in a 41-yr-old female patient with advanced gastric carcinoma. An emergency exploratory laparotomy was performed but revealed no evidence of ovarian torsion. Only chylous ascites was discovered in the operative field. She underwent a complete abdominal hysterectomy and salphingo-oophorectomy. Only saline irrigation and suction-up were performed for the chylous ascites. The postoperative course was uneventful. Her bowel movement was restored within 1 week. She was allowed only a fat-free diet, and no evidence of re-occurrence of ascites was noted on clinical observation. She now remains under consideration for additional chemotherapy.
Subject(s)
Adult , Female , Humans , Abdomen, Acute/etiology , Chylous Ascites/diagnosis , Diagnosis, Differential , Ovarian Diseases/diagnosis , Stomach Neoplasms/complications , Torsion Abnormality/diagnosisABSTRACT
To compare the pediatric and adult ovarian torsion and explore a quantitative value to predict a possible underlying tumor. This study included 32 pediatric and 33 adult female cases diagnosed with ovarian torsion and underwent surgical treatment in Dr. Behcet Uz Children's Research Hospital and Ataturk Education and Research Hospital, Izmir, Turkey between 1989 and 2005. We evaluated the properties of the cases statistically. The mean age of pediatric was 8 years and 3 months and adult cases was 39 years and 8 months. Six cases had an underlying tumor in both pediatric and adult group. The mean diameter and volume difference were 6.84 cm, 91 cc in pediatric and 12.69 cm and 1087 cc in the adult group. In statistical analysis, the diameter and volume increase were significantly higher in cases with underlying tumor in pediatric group. The cut-off value was 7 cm in diameter and 104 cc in volume increase. In the adult group, the diameter and volume increase were not significant in tumor positive and negative group. Torsion of the ovary requiring surgery, is rare and is the mot common reason of abdominal/pelvic mass. These cases are often difficult to decide for surgical procedure especially in pediatric cases. We conclude that an underlying lesion more commonly occurs in children with an increase in ovarian volume of more than 104 cc and a diameter more than 7 cm. Great care should be taken for laparoscopic conservative management especially in these cases. The quantitative analysis is not predictive for the underlying solid lesion in adult cases
Subject(s)
Humans , Female , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/surgery , Torsion Abnormality/etiology , Torsion Abnormality/diagnosis , Torsion Abnormality/surgery , Ovarian Diseases/etiology , Cysts/complications , Ovary/pathology , Age FactorsABSTRACT
A young married women in her 3rd ongoing pregnancy, having no alive issue presented at 37+ weeks with labor pains. Cesarean section was planned because of twin pregnancy and past bad obstetrical history. During operation, the uterus was found to have rotated to 180 degree to the right. A transverse incision was made on posterior wall of uterus to deliver babies. After suturing the incision site, the uterus was repositioned in right place. This paper presents a case of torsion of gravid uterus in which the delivery and repositioning of the uterus was successful