IMR Press / EJGO / Volume 23 / Issue 6 / pii/2002235

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Case Report

Intraperitoneal haemorrhage secondary to perforation of uterine fibroid after cystic degeneration. Unusual CT findings resembling malignant pelvic tumor: case report

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1 Department of Gynaecology, “George Gennimatas” General State Hospital of Athens, Second District National Health System, Athens (Greece)
2 Department of Ultrasound, Computed Tomography, MRI , “George Gennimatas” General State Hospital of Athens, Second District National Health System, Athens (Greece)
3 Department of Pathology, “George Gennimatas” General State Hospital of Athens, Second District National Health System, Athens (Greece)
Eur. J. Gynaecol. Oncol. 2002, 23(6), 565–568;
Published: 10 December 2002
Abstract

Intraperitoneal haemorrhage is a rare complication of myomatous uterus. We present a case of a 37-year-old white nullipara who presented in the emergency room with acute, lower-abdominal pain which reportedly started after riding over a bump on a motorcycle. On examination, the abdomen was diffusely tender, with moderate spasm and rebound tenderness in both iliac fossae. Pregnancy test was negative. Computed tomography revealed a soft-tissue mass with cystic components and inhomogeneous appearance. Free fluid in the peritoneal cavity suggested ascites. The patient underwent an exploratory laparotomy. A ruptured, actively bleeding, subserosal, nonpedunculated, cystic degenerated uterine fibroid was found, as well as approximately two liters of free, bloodstained peritoneal fluid and clots. Subtotal hysterectomy without salpingo-oophorectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, definitive, preoperative diagnosis of a perforated, haemorrhaging, uterine fibroid is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening con­dition.

Keywords
Uterus
Computered tomography
Fibroid
Uterine myoma
Rupture
Haemoperitoneum
Cystic degeneration
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