Hemoperitoneum Caused by Spontaneous Rupture of Uterine Leiomyoma in a Perimenopausal Woman

Abstract

Uterine fibroid, or leiomyoma, is a common benign neoplasm in women, but serious complications are rarely reported. We present the case of a 48-year-old woman with acute onset of abdominal pain. She was hemodynamically unstable, and computed tomography revealed abundant fluid collection in the peritoneal cavity, suggesting hemoperitoneum. During emergency exploratory laparotomy, the subserosal vein overlying a uterine fibroid was identified as the source of bleeding. Hemostasis was accomplished with fibroid excision. Spontaneous hemorrhage originating from a uterine fibroid is extremely rare, but may lead to life-threatening conditions. Therefore, in female patients with acute abdominal pain and hemoperitoneum, uterine fibroid may be a potential etiology and emergency exploratory laparotomy should be considered.

Emergency laparoscopic myomectomy in a rare case of hemoperitoneum from uterine leiomyoma

“…[14][15][16] Most of the cases reported in literature were managed by laparotomy and here we present the laparoscopic management of emergency myomectomy. 7,14,17 In our case, a pre-operative differential diagnosis was sorted andadequate facility for fluid replacementensured and once in-detail counselling for laparoscopy was done, emergency laparoscopy with emergency laparoscopic myomectomy and evacuation of organised blood clots done. As she was laparoscopically managed without delay, patient recovery was rapid and satisfactory.…”

A rare cause of hemoperitoneum – Gynecological emergency

“…Uterine fibroids are reported to occur in ~25% of females in the reproductive age group. [1] It is also the most common benign smooth muscle tumor of uterus. Sub-serosal fibroid is a type of uterine fibroid which may be attached directly to the uterus or by a thin stalk, which is also known as a pedunculated fibroid.…”

Large-volume hemoperitoneum and hemodynamic instability in uterine fibroid rupture: A case report

“…Another uncommon but devastating complication is the spontaneous rupture of a uterine fibroid, which can precipitate intra-abdominal hemorrhage and hypovolemic shock. Reports on this acute complication are limited, and so it is easily misdiagnosed or inadequately treated [ 5 ]. The case presented here of intraperitoneal hemorrhage derived from a ruptured uterine leiomyoma demonstrates the importance of considering ruptured fibroids as a possible diagnosis in patients presenting with acute abdominal pain.…”