What's the most likely diagnosis?

• 41 year-old female with abdominal fullness

1. Small bowel obstruction
2. Term pregnancy
3. Lymphoma
4. Uterine fibroids
5. Bladder outlet obstruction

Additional Image-Coronal CT of Abdoman and Pelvis

 

Additional Image

 

Reformatted Coronal View of Abdominal and Pelvic CT

Answer:

 

4. Uterine Fibroids

 

 

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Uterine Fibroids

General Considerations

• Uterine fibroids are leiomyomas, benign tumors of smooth muscle origin
• Occur in between 20-50% of women > 30 years of age
• Fibroids may enlarge with elevated estrogen levels
  • They enlarge during the first trimester of pregnancy
• Uterine fibroids diminish in size after menopause
• More common in blacks than whites (3:1)
• Most are intramural, i.e. middle of myometrium
• Most fibroids are in the fundus and body of the uterus
  • Others can be subserosal or exophytic, or
• Submucosal and subendometrial (rarely)

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