Challenge in the diagnosis of torsion of a pedunculated uterine leiomyoma.

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.