Intra‐leiomyoma massive hemorrhage after delivery

Manopunya, Manatsawee; Tongprasert, Fuanglada; Sukpan, Kornkanok; Tongsong, Theera

doi:10.1111/j.1447-0756.2012.01932.x

Cited by 11 publications

(11 citation statements)

References 8 publications

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“…Two patients were identified in the immediate post-partum state. The authors hypothesized that involution of the uterus after delivery promoted compression of venous drainage, but not arterial flow [15,16]. This would lead to a large amount of blood sequestration from maternal circulation into the fibroid, resulting in hypovolemia without haemoperitoneum.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal haemorrhage from uterine fibroids: a systematic review of the literature

2020

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Background: Uterine leiomyomas are common benign tumours found in women of reproductive age that are rarely associated with intra-abdominal haemorrhage. The aetiology behind this relationship is poorly understood and the aforementioned association poorly recognized from a patient's clinical presentation. Available information in the literature is limited to case reports. The aim of this systematic review is to document and highlight the occurrence of intra-abdominal haemorrhage from uterine fibroids, and determine associated morbidity and mortality. Methods: A systematic review of Medline, EMBASE, Web of Science, Scopus, and The Cochrane Library -CENTRAL was performed from the databases inception through to December 2018 for case report and series of patients who experienced intra-abdominal haemorrhage from uterine fibroids. Findings were presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: We identified 115 publications reporting on 125 original case reports. The documented intra-abdominal haemorrhage were commonly due to the rupture of superficial blood vessels over the surface of a fibroid, followed by rupture and avulsion of the fibroid involved. A clinical picture of sudden and profound hypovolemic shock with severe abdominal pain was often the presenting complaint, with a correct pre-operative diagnosis only made in 7 cases on computed tomography imaging. Hysterectomy and myomectomy were the most common surgery performed. Mortality was reported in 4 cases which were directly related to complications of uterine fibroids. Conclusion: Intra-abdominal haemorrhage secondary to uterine fibroids remained a rare phenomenon which is poorly recognized among clinicians. While this association is not representative of the population of interest, it highlights the pathophysiological spectrum of uterine fibroids and its relevance to emergency physicians, surgeons and gynaecologists during clinical practice.

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Section: Discussionmentioning

confidence: 99%

Intra-abdominal haemorrhage from uterine fibroids: a systematic review of the literature

2020

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“…6 Various causes of acute abdomen with fibroid uterus have been known, but massive haemoperitoneum secondary to spontaneous rupture of a vessel overlying a myoma is rare. 3,7,8 Abdominal trauma, sudden exertion, straining, and erosion of vessels by friction or pressure of the tumour against sacral promontory are few of its predisposing factors. 2 In the above discussed case, the patient was unaware of mass in her abdomen and thus seeked medical attention in view of abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

Massive hemoperitoneum in case of large subserosal fibroid- a rare case report

Jadeja

Shukla

Vaishnav

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Rupture of veins on the surface of uterine leiomyoma is an extremely uncommon gynaecological cause of haemoperitoneum. It is a life-threating emergency. In most cases, bleeding is a result of trauma or torsion. Here we report a case of massive intraperitoneal haemorrhage due to rupture of vessels on the surface of large sub-serous leiomyoma to stress on the fact that a differential diagnosis of rupture of surface vessels in a fibroid should be considered while dealing with a case of haemoperitoneum with pelvic masses

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“…[5] The bleeding is likely to occur from torn enlarged veins coursing over the surface of subserous leiomyomas, resulting in hemoperitoneum and hypovolemic shock. [4]…”

Section: Discussionmentioning

confidence: 99%

“…[1] Spontaneous hemoperitoneum due to fibroid rupture is a rare entity with less than 100 cases reported in the literature. [34] Intratumor massive bleeding leading to hypovolemia is extremely rare. Only two cases were reported by Koide et al ., and Manopunya et al .,[4] just after delivery.…”

Section: Introductionmentioning

confidence: 99%

“…[34] Intratumor massive bleeding leading to hypovolemia is extremely rare. Only two cases were reported by Koide et al ., and Manopunya et al .,[4] just after delivery. In this case report, we report the case of spontaneous uterine intraleiomyoma hemorrhage, perforation, and hemoperitoneum in postmenopausal woman diagnosed by computed tomography (CT) and confirmed by laparotomy and pathological diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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