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Case Reports in Obstetrics and Gynecology
Volume 2017, Article ID 3701450, 3 pages
https://doi.org/10.1155/2017/3701450
Case Report

Spontaneous Rupture of a Leiomyoma Causing Life-Threatening Intra-Abdominal Hemorrhage

1Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, 9th Floor, 1176 Fifth Avenue, New York, NY 10029, USA
2Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine and Montefiore Medical Center, 5th Floor, 1300 Morris Park Avenue, Bronx, NY 10461, USA

Correspondence should be addressed to Melissa Schwartz; gro.ianistnuom@ztrawhcs.assilem

Received 27 October 2016; Revised 15 December 2016; Accepted 18 December 2016; Published 3 January 2017

Academic Editor: Yoshio Yoshida

Copyright © 2017 Melissa Schwartz and Kristin Powell. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy. Surgery revealed 4.5 L of hemoperitoneum and a 15 cm degenerated uterine fibroid with active bleeding. Pathology was consistent with intraoperative findings. She required transfusion of numerous blood products perioperatively. Her postoperative course was uncomplicated. Conclusion. It is rare for a uterine fibroid to spontaneously rupture. However, prompt recognition of this severe complication is critical for expeditious, life-saving surgical management.