Marco Zaccaria: When a Uterine Fibroid Twists, Recognizing a Surgical Emergency!
Marco Zaccaria, Global Product Manager at ESGE European Society Gynecology Endoscopy, shared a post on LinkedIn:
“Torsion of the pedicle of a uterine fibroid is a rare but serious acute surgical emergency
It occurs when a pedunculated fibroid (that is, a mass connected to the uterus by a thin strand of tissue or vascular stalk) rotates on its own axis
This rotation suddenly cuts off the blood supply to the fibroid, triggering rapid necrosis and potentially leading to acute abdominal symptoms
This condition occurs primarily in pedunculated subserosal fibroids FIGO Type 7, which grow outward from the uterus into the pelvic or c, allowing the benign tumor to move and rotate freely
The symptoms appear suddenly and require immediate medical attention:
- Acute abdominal pain: Sudden, sharp, and constant pain in the pelvis or lower abdomen
- Signs of reactive peritonitis: A rigid abdomen that is tender to the touch, often accompanied by fever and nausea
- Systemic compromise: In more advanced cases, extreme fatigue, vomiting, tachycardia, and shock symptoms related to tissue necrosis may occur.”

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