No abstract

Uterine leiomyomata are the most common pelvic tumours in women. Haemoperitoneum caused by bleeding from uterine leiomyomata is extremely rare and requires prompt diagnosis and surgical management. We report a case of massive haemoperitoneum in a 47-year-old woman who presented with abdominal pain and shock in the accident and emergency department. Contrast computed tomography showed a large (14 cm) subserosal fibroid, but there was no obvious cause for the haemoperitoneum. Emergency laparotomy was performed; the bleeding was due to spontaneous rupture of a superficial vein on the large fibroid and thus total hysterectomy was performed. Despite its rarity, bleeding from fibroid vessels should be included in the differential diagnosis for women presenting with a large fibroid and haemoperitoneum without obvious cause.