Uterine inversion during puerperium is an obstetric emergency, and it is an even rarer complication posing a diagnostic challenge in gynaecology. Non puerperal uterine inversion is mostly associated with benign uterine pathology such as leimyomas. Treatment depends on the associated pathology and stage of inversion. A rare case of acute non-puerperal total uterine inversion caused by multiple fundal leiomyomas in a 47-year-old woman resulting in profuse vaginal bleeding is reported; it was successfully treated by vaginal hysterectomy.

The postoperative period was uneventful, and the patient was discharged in good condition. Acute complete uterine inversion is rare in non-pregnant women, and there are only a few reported cases worldwide. It therefore poses a diagnostic dilemma to the unsuspecting gynaecologist, and therefore a high index of suspicion is needed to differentiate it from uterovaginal prolapse or a prolapsed fibroid, as the clinical presentations can be similar.

Dr. Shirish Dulewad is a Associate Professor at Dr. Shankarrao Chavan Government Medical College and Hospital in Maharashtra, India.