Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan.
BMJ Case Rep. 2021 May 28;14(5):e241782. doi: 10.1136/bcr-2021-241782.
Intra-abdominal bleeding due to uterine fibroids is extremely rare, and preoperative diagnosis is difficult. Herein, we report a case of preoperatively diagnosed hypovolaemic shock due to intra-abdominal haemorrhage, in which fatal sequelae were prevented. A 46-year-old non-pregnant woman was brought to the hospital with a sudden-onset lower abdominal pain. On admission, she was in shock, and abdominal CT showed severe intra-abdominal haemorrhage. Since bleeding from uterine fibroids was suspected, an emergency simple total hysterectomy was performed, and her condition became stable after the operation. Intra-abdominal haemorrhage with hypovolaemic shock requires prompt surgical intervention. Although it occurs very rarely due to bleeding from uterine fibroids, imaging shows large fibroids; if the patient is not pregnant, bleeding from the fibroids should be considered.
由于子宫肌瘤导致的腹腔内出血极其罕见，术前诊断困难。在此，我们报告一例术前诊断为低血容量性休克的腹腔内出血病例，该病例成功预防了严重后果。一名 46 岁未怀孕女性突发下腹疼痛，被送入医院。入院时，患者休克，腹部 CT 显示严重腹腔内出血。由于怀疑是子宫肌瘤出血，紧急进行了单纯全子宫切除术，术后患者情况稳定。由于子宫肌瘤出血导致的腹腔内出血伴低血容量性休克需要立即手术干预。虽然由于子宫肌瘤出血引起的这种情况非常罕见，但是影像学检查显示有大的肌瘤；如果患者未怀孕，应考虑子宫肌瘤出血。
