Haemoperitoneum secondary to rupture of a superficial vein on a subserosal uterine fibroid: a case report Abstract

Hing Ting YU, Horace Him Chun CHEUNG, Joyce Chung Yin CHAN, Choi Wah KONG
Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong

Uterine leiomyomata are the most common pelvic tumours in women. Haemoperitoneum caused by bleeding from uterine leiomyomata is extremely rare and requires prompt diagnosis and surgical management. We report a case of massive haemoperitoneum in a 47-year-old woman who presented with abdominal pain and shock in the accident and emergency department. Contrast computed tomography showed a large (14 cm) subserosal fibroid, but there was no obvious cause for the haemoperitoneum. Emergency laparotomy was performed; the bleeding was due to spontaneous rupture of a superficial vein on the large fibroid and thus total hysterectomy was performed. Despite its rarity, bleeding from fibroid vessels should be included in the differential diagnosis for women presenting with a large fibroid and haemoperitoneum without obvious cause.