Spontaneous Rupture of a Leiomyoma Causing Life-Threatening Intra-Abdominal Hemorrhage

Abstract EN

Background.

Uterine fibroids are common benign tumors in women.

Clinical manifestations are well known.

Acute complications necessitating emergent surgical intervention are rare.

Case.

We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain.

Imaging indicated massive free fluid and a large partially solid uterine mass.

Vitals were consistent with hypovolemic shock.

Examination revealed a surgical abdomen.

She underwent an emergent laparotomy and total hysterectomy.

Surgery revealed 4.5 L of hemoperitoneum and a 15 cm degenerated uterine fibroid with active bleeding.

Pathology was consistent with intraoperative findings.

She required transfusion of numerous blood products perioperatively.

Her postoperative course was uncomplicated.

Conclusion.

It is rare for a uterine fibroid to spontaneously rupture.

However, prompt recognition of this severe complication is critical for expeditious, life-saving surgical management.