Author(s)

Kyousuke Takeuchi, Makoto Sugimoto, Taro Tsujino, Riichiro Nishino

Department of Obstetrics and Gynecology, Kobe Medical Center, Kobe, Japan.

Spontaneous venous rupture overlying a uterine fibroid is a rare cause of hemoperitoneum. A 38-year-old woman presented to the emergency department with acute onset of abdominal pain. The ultrasound revealed multiple fibroids and free fluid in the peritoneum. There was a significant drop of the hemoglobin and hematocrit. The patient underwent emergent exploratory laparoscopy. A subserosal uterine leiomyoma was found, with a bleeding vein on its basis and massive hemoperitoneum. Laparoscopic myomectomy was successfully performed with local injection of vasopressin and intraoperative autologous blood transfusion. This case suggests that spontaneous intraperitoneal haemorrhage associated with uterine fibroids, although rare, should be considered in women with hypovolemic shock and a pelvic mass.

Laparoscopy; Uterine Fibroid; Venous Rupture; Hemoperitoneum; Intraoperative Autologous Blood Transfusion

Takeuchi, K. , Sugimoto, M. , Tsujino, T. and Nishino, R. (2012) Successful laparoscopic management of hemoperitoneum due to spontaneous venous rupture overlying a uterine fibroid. Open Journal of Obstetrics and Gynecology, 2, 164-166. doi: 10.4236/ojog.2012.22032.