Hemoperitoneum from ruptured vein overlying a uterine myoma: a case report and review of the literature

Abstract

Hemoperitoneum from ruptured vein overlying a uterine myoma: a case report and review of the literature A. Oride1,H. Kanasaki1,T. Hara1,S. Kyo1 1Department of Obstetrics and Gynecology, Faculty of Medicine, Shimane University, Izumo, Shimane (Japan) Summary Uterine myomas are very common tumors in women, but there are few reports of cases causing hemoperitoneum. Here, the authors report a case of a ruptured vein overlying a uterine myoma due to trauma. A 28-year-old nulliparous woman with a history of uterine myomas came to the emergency department with acute lower abdominal pain after falling on her hip while snowboarding. Ultrasound and contrast-enhanced computed tomography revealed multiple myomas and free fluid in the pelvic cavity. Her vital signs became unstable and an emergency laparotomy was performed. There was massive hemorrhage into the abdominal cavity and venous rupture over the site of a subserosal myoma. Following myomectomy, the bleeding stopped and her vital signs gradually became stable. Rupture of a vein overlying a uterine myoma is rare; however, intra-abdominal bleeding should be considered in women with a history of large fibroid presenting with shock and circulatory collapse with or without a history of trauma. Key words: Intraperitoneal hemorrhage; Ruptured uterine leiomyoma; Trauma.