Acute Neglected Non-Puerperal Uterine Inversion about a Case at the Mother and Child Health Center (CSME) in Zinder

Introduction: Uterine inversion is defined as an invagination of the uterine fundus in a “finger-like inversion”, which protrudes through the vagina and vulva. It is a rare pathology, more common in obstetrics than in gynecology. The objective of the study was to report a case of acute neglected nonpuerperal uterine inversion treated at the CSME of Zinder. Clinical Observation: We describe a case of non-puerperal uterine inversion in a 45-year-old woman G10P7V5A3 housewife referred from a district hospital for mass protruding from the vagina evolving for several weeks, she had a history of several hospitalizations for blood transfusion and one reports a notion of attempted vaginal ablation of the myoma with failure. On a functional level, she presented the clinical picture of metrorrhagia associated with pelvic discomfort. On general examination the conjunctivas were discolored. The uterus is not palpable above the pubis. On inspection of the vulva, we note the presence of a multilobed, fleshy mass with a reddish appearance overlooked by a whitish mass bleeding on contact and a discharge of pus. The mass appears myomatous in appearance and overhangs the invaginated uterine fundus. The diagnosis of uterine inversion due to myoma was made. The blood count showed microcytic normochromic anemia with a hemoglobin level of 6.6g/dl, white blood cells of 8.3103 and rhesus B positive blood group. She received a blood transfusion before surgery. Myomectomy was the first procedure then laparotomy with posterior median incision of the uterus with repositioning of the uterus in the abdominal cavity and total hysterectomy with preservation of the adnexa was performed. Conclusion: non-puerperal uterine inversion is rare. We found a case of neglected acute uterine inversion in a multiparous patient with a uterus carrying a myoma, in whom the attempt to extract a myoma delivered through the cervix resulted in acute uterine inversion, the diagnosis of which and treatment was provided late. The treatment was radical surgery