Galal Lotfi, MD. MRCOG

Prof. Obstetrics & GynecologySuez Canal University

Egypt

The patient

33 year old mother of two children, presented herself with multiple myomata reaching the xiphisternum with a main complaint of pressure symptoms and difficult breathing. She had a pfannenstiel scar for her two cesarean sections; last one was two years earlier. Laparotomy through pfannenstiel incision and muscle cutting was carried out. There was a 40x 40cm cauliflower broad ligament fibroid with the uterus just sitting on it. Successful myomectomy was carried out. 

Ovary

Uterus

Tube

Part of the Mass

The other half of the mass was still incarcerated in the pouch of Douglas, Not Out

Yet

Almost half of the broad

ligament myoma is now out

but still the other half

was incarcerate

d in the pouch of Douglas

The there half in now out

Uterus

Uteru

Uterus

Outcome

• Myoma was removed, 40x40 Cm, 8.5Kg weight

• Uterus, both ovaries and tubes were left intact

• Post operative was uneventful