Ruptured Degenerated Uterine Fibroid Diagnosed by Imaging

Kamat, Nikhil; Telkar, Hemant B.; Ramani, Subhash; Thakker, Ajay P.

doi:10.1097/00006250-200111001-00030

Cited by 6 publications

(8 citation statements)

References 3 publications

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“…Degeneration of leiomyomas resulting in rupture has also been described in both pregnant and nonpregnant patients [1][2][3]. In addition, cases of spontaneous perforation involving significant degeneration on pathologic finding occurred in the context of infection post dilation and curettage [1], ascites [10], and increased intra-abdominal pressure from physical activity [2]. Our case did not have degenerative changes of the leiomyoma and was not associated with any significant identifiable provoking factors.…”

Section: Discussionmentioning

confidence: 53%

“…Large intraperitoneal hemorrhage from leiomyomas has been reported as a result of ruptured surface subserosal veins [8,9]. Degeneration of leiomyomas resulting in rupture has also been described in both pregnant and nonpregnant patients [1][2][3]. In addition, cases of spontaneous perforation involving significant degeneration on pathologic finding occurred in the context of infection post dilation and curettage [1], ascites [10], and increased intra-abdominal pressure from physical activity [2].…”

Section: Discussionmentioning

confidence: 99%

“…Leiomyomas are common benign tumors and can undergo degeneration. Rupture of degenerated uterine leiomyomas to cause acute intraperitoneal hemorrhage is extremely rare with only case reports in the literature so far [1][2][3][4][5][6][7][8][9][10]. The pathological finding in these leiomyomas had significant degenerative changes or was associated with other factors such as infection [1], activity [2], and pregnancy [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography

Shan

Harjee

McLaughlin

et al. 2020

Case Reports in Obstetrics and Gynecology

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Background. Spontaneous rupture of benign uterine fibroids is extremely rare and has been associated with fibroid degeneration. It can cause acute intraperitoneal bleeding requiring immediate surgical intervention. Case. A previously healthy 50-year-old, Caucasian, nullipara presented with syncope, hemodynamic instability, and an acute abdomen. Noncontrast computed tomography images showed a positive sentinel clot sign in the pelvis as well as a large uterine fibroid with internal hyperdense clot suggesting acute rupture. Urgent laparotomy and hysterectomy confirmed a ruptured, actively bleeding, uterine fibroid with final pathological diagnosis of a benign leiomyoma. Conclusion. Prompt diagnosis and emergency surgical intervention were necessary to control acute hemorrhage from a ruptured uterine fibroid. Noncontrast computed tomography is an important adjunct to contrast-enhanced computed tomography and was vital for diagnosis in this case.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography

Shan

Harjee

McLaughlin

et al. 2020

Case Reports in Obstetrics and Gynecology

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“…5,6,9,10 However, according to some reports, the rupture of a degenerated leiomyoma caused no intra-abdominal bleeding but caused peritonitis due to leakage of the fluid content of the degenerated leiomyoma into the peritoneal cavity. 11,12 Our case is considered similar to the latter case. In addition to the pain caused by leiomyoma degeneration, if intraperitoneal bleeding, peritonitis, or ileus is present, leiomyoma rupture should be considered.…”

Section: Discussionmentioning

confidence: 75%

Spontaneous rupture of a degenerated leiomyoma causing peritonitis and ileus during pregnancy: A case report

Odagami

Makino

Miyagi

et al. 2020

Clinical Case Reports

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“…The diagnosis of ruptured uterine fibroid may be clinically difficult but can be aided in correctly establishing the diagnosis via imaging using computed tomography (CT) and magnetic resonance imaging (MRI). 6 Ultrasonography could demonstrate collection in the abdominal cavity that may indicate a rupture but it is not specific. Nonetheless, an exploratory laparotomy may be both diagnostic and therapeutic.…”

Section: Discussionmentioning

confidence: 99%

Rare postpartum ruptured degenerated fibroid: A case report

Tan

Naidu

2014

J of Obstet and Gynaecol

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Spontaneous rupture of uterine fibroid is rarely encountered. We present a case of a 31-year-old who presented with acute abdominal pain at 9 weeks postpartum. On examination, the abdomen had diffuse tenderness, with rebound tenderness in the suprapubic area and in both iliac fossae. On ultrasonography, a 12.7 × 8.6 × 8.9-cm sized hyperechoic mass was visible on the posterior wall of the uterus. A large amount of fluid was visible in the paracolic gutters and the Pouch of Douglas (POD). The patient underwent an exploratory laparotomy. A ruptured, cystic degenerated uterine fibroid with active bleeding was found, as well as approximately half a liter of free, bloodstained peritoneal fluid and pus. Myomectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, preoperative diagnosis of a perforated, uterine fibroid with spontaneous intra-abdominal hemorrhage is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.

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Ruptured Degenerated Uterine Fibroid Diagnosed by Imaging

Cited by 6 publications

References 3 publications

Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography

Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography

Spontaneous rupture of a degenerated leiomyoma causing peritonitis and ileus during pregnancy: A case report

Rare postpartum ruptured degenerated fibroid: A case report

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