Althobaiti Faisal Abdulrahman, Alsaadi Khulod Khaled, Althobaiti Awwadh Abdulrahman
Medical Department, College of Medicine, Taif University, Taif, Saudi Arabia.
Department of Obstetrics and Gynecology, King Abdulaziz Hospital, Jeddah, Saudi Arabia.
Am J Case Rep. 2019 Feb 8;20:167-170. doi: 10.12659/AJCR.914573.
BACKGROUND Uterine leiomyoma, or uterine fibroid, is the most common gynecologic neoplasm and its management usually results in a good clinical outcome. This report is of a rare case of hemoperitoneum associated with spontaneous hemorrhage from a benign uterine leiomyoma. CASE REPORT A 27-year-old single woman presented with generalized acute abdominal pain and vomiting. Clinical examination showed a distended abdomen and unstable vital signs. Following active resuscitation, ultrasound and computed tomography (CT) imaging showed an intraperitoneal fluid collection and heterogenous uterine mass. The patient underwent emergency laparotomy with the identification of bleeding blood vessels, which were clipped, resulting in hemostasis. The uterine lesion was completely excised and histopathology confirmed the diagnosis of benign leiomyoma. The patient's postoperative course was unremarkable. Five days following admission, the patient was discharged from hospital without further complications. CONCLUSIONS Hemoperitoneum secondary to spontaneous hemorrhage from a benign uterine leiomyoma is rare. This case demonstrates that clinical history, imaging, and surgical exploration are required to identify and control the source of bleeding to prevent a potentially fatal outcome.
背景 子宫平滑肌瘤，又称子宫肌瘤，是最常见的妇科肿瘤，其治疗通常会取得良好的临床效果。本报告介绍了一例罕见的与良性子宫平滑肌瘤自发性出血相关的腹腔积血病例。病例报告 一名27岁单身女性因突发全腹疼痛和呕吐就诊。临床检查发现腹部膨隆，生命体征不稳定。积极复苏后，超声和计算机断层扫描（CT）成像显示腹腔内有液体积聚和子宫内不均匀肿块。患者接受了急诊剖腹手术，术中发现出血血管并予以夹闭止血。子宫病变被完整切除，组织病理学确诊为良性平滑肌瘤。患者术后恢复顺利。入院五天后，患者出院，无进一步并发症。结论 良性子宫平滑肌瘤自发性出血继发腹腔积血罕见。本病例表明，需要结合临床病史、影像学检查和手术探查来识别和控制出血源，以防止潜在的致命后果。
