Haemoperitoneum secondary to rupture of a superficial vein on a subserosal uterine fibroid: a case report
DOI:
https://doi.org/10.12809/hkjgom.23.1.05Abstract
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.
References
Giuliani E, As-Sanie S, Marsh EE. Epidemiology and management of uterine fibroids. Int J Gynaecol Obstet 2020;149:3-9.
Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG 2017;124:1501-12.
Levai AM, Rotar IC, Muresan D. Torsion of a uterine leiomyoma — a rare cause of hemoperitoneum; a case report and review of the literature. Med Ultrason 2019;21:77-82.
Daimon A, Tanaka T, Kogata Y, Tanaka Y, Fujita D, Ohmichi M. Hemoperitoneum associated with uterine fibroids: a case report. Medicine (Baltimore) 2021;100:e24024.
Beuran M, Negoi I, Hostiuc S, et al. Laparoscopic approach has benefits in gynecological emergencies — even for massive hemoperitoneum. Chirurgia (Bucur) 2016;111:48-53.
Elkbuli A, Shaikh S, McKenney M, Boneva D. Life-threatening hemoperitoneum secondary to rupture of a uterine leiomyoma: a case report and review of the literature. Int J Surg Case Rep 2019;61:51-5.
Horowitz E, Dekel A, Feldberg D, Rabinerson D. Massive hemoperitoneum due to rupture of an artery overlying a uterine leiomyoma: a case report. Acta Obstet Gynecol Scand 2005;84:408-9.
Ihama Y, Miyazaki T, Fuke C. Hemoperitoneum due to rupture of a subserosal vein overlying a uterine leiomyoma. Am J Forensic Med Pathol 2008;29:177-80.
Althobaiti FA, Alsaadi KK, Althobaiti AA. A case of hemoperitoneum due to spontaneous bleeding from a uterine leiomyoma. Am J Case Rep 2019;20:167-70.
Godt JC, Eken T, Schulz A, Øye K, Hagen T, Dormagen JB. Do we really need the arterial phase on CT in pelvic trauma patients? Emerg Radiol 2021;28:37-46.
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