TITLE:
Successful laparoscopic management of hemoperitoneum due to spontaneous venous rupture overlying a uterine fibroid
AUTHORS:
Kyousuke Takeuchi, Makoto Sugimoto, Taro Tsujino, Riichiro Nishino
KEYWORDS:
Laparoscopy; Uterine Fibroid; Venous Rupture; Hemoperitoneum; Intraoperative Autologous Blood Transfusion
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.2 No.2,
June
27,
2012
ABSTRACT: 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.