Spontaneous Rupture of a Leiomyoma Causing Life-Threatening
Uterine fibroids are common benign tumors in women. Most women with fibroids are asymptomatic. However, when clinically apparent, women usually experience heavy or prolonged menstrual bleeding or pelvic pressure. Acute complications secondary to fibroids are rare and seldom necessitate immediate surgical intervention. Such complications include thromboembolism, acute pain due to degeneration or torsion of a pedunculated fibroid, acute urinary retention and subsequent renal failure, and acute intra-abdominal blood loss. It is imperative to recognize and diagnose acute complications from fibroids as failure to do so can result in significant morbidity and even mortality. We report herein a case of spontaneous rupture of a degenerated fibroid causing life-threatening blood loss necessitating massive transfusion and emergent surgery.

A 53-year-old (gravida 2, para 2) perimenopausal African-American woman presented to the emergency department with worsening severe, acute-onset abdominal pain. The patient also reported dizziness and nausea. Her past medical history was significant for hypertension and known uterine fibroids. Vitals were notable for blood pressure 78/50?mm?Hg and pulse rate 116?bpm. Examination revealed a 14-week-sized fibroid uterus, a distended abdomen, and diffuse abdominal tenderness with positive rebound and guarding. Hemoglobin concentration was initially 10.6?g/dL. A bedside abdominal sonogram was performed which revealed a large amount of free fluid, extending into Morison's pouch....

Dr. H●●●●h D●●●i
Dr. H●●●●h D●●●i Obstetrics and Gynaecology
Fibroids are so common & benign that women live with them for years without much problem. As surgery is the only definite treatment, many women avoid it due to fear of surgery or other reasons. But such rare complications do occur so patients & her gynecologists should be aware of this.
Feb 6, 2017Like