This shows the uterus with two subserous leiomyomata apparent at the fundus; there is a large
ovarian cyst present which is purple in colour, the result of twisting of the ovary on its pedicle.
This woman was admitted at the age of 42, following the sudden onset of severe pain in
the right iliac fossa. The pain was persistent, and examination showed that she was tender in the
right iliac fossa, with marked guarding, and showed rebound tenderness. A mass was felt in the
right fornix and, at laparotomy, the uterus and cyst were removed; the uterus was removed because
she gave a history of menorrhagia and had been on the waiting list for hysterectomy.