Broad Ligament Haematoma

Incidental Finding of a Broad Ligament Hematoma During Tubal Ligation Surgery: A Case Report and Literature Review

“…Pallor, hypotension, tachycardia, abdominal pain, and vaginal bleeding can be observed. Abnormal uterine displacement or irregular uterine contour per abdomen should raise suspicion of postpartum supra levator hematoma [ 1 ]. Our case was similar to that of Mendel et al, who reported two cases; a gravida 7 para 4 and a gravida 4 para 3 both presented after one day of normal vaginal delivery as a silent incomplete uterine rupture was incidentally diagnosed during postpartum tubal ligation [ 11 ].…”

“…Although magnetic resonance imaging is the most precise investigation for detecting retroperitoneal hematoma, ultrasonography is readily available, inexpensive, non-invasive, and highly sensitive [ 1 ].…”

“…As there are no obvious symptoms of vaginal bleeding or pain, diagnosis gets delayed. Unexplained shock out of proportion to blood loss should raise a suspicion of internal bleeding [ 1 ]. Broad ligament hematomas and retroperitoneal hematomas, which form due to injury to the uterine artery or vein, or a tear in the upper vagina, cervix, or uterus that extends into uterine or vaginal arteries, and have a higher morbidity and mortality rate [ 2 ].…”

“…Diagnostic imaging studies, including ultrasonography, computed tomography scan, and magnetic resonance imaging, show the volume of estimated blood loss along with the extent of the hematoma. Treatment is variable depending on the size, location of the hematoma, and the patient's hemodynamic stability [ 1 ]. Comprehensive treatment options for broad ligament hematomas include internal iliac artery ligation, angiographic embolization, and hysterectomy [ 3 ].…”