The goal of this
investigation was to determine the incidence of findings in asymptomatic
patients which were suggestive of outflow obstruction (venous or lymphatic) as
evidenced by dilated lymphatics and ovarian engorgement/signs of massive ovarian
edema and to correlate these findings with the size of the fibroid uterus as
compared to an age matched control population without fibroids. Ovarian edema and/or
lymphatic dilatation was noted with increased frequency in asymptomatic
patients imaged for fibroid uterus over asymptomatic female patients without a
fibroid uterus imaged for other causes (p< 0.0001). Ovarian edema and/or
dilated lymphatics in the setting of large fibroid uteri may be due to vascular
congestion or lymphatic obstruction. In the absence of pain and symptoms
concerning for ovarian torsion, we postulate that these are incidental findings
and recommend conservative management as opposed to immediate surgical
exploration.
