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Uterine leiomyoma with spontaneous intraleiomyoma hemorrhage, perforation, and hemoperitoneum in postmenopausal woman: Computed tomography diagnosis.

Alharbi SR - Avicenna J Med (2013)

Bottom Line: Spontaneous intraleiomyoma hemorrhage, perforation, and hemoperitoneum are very rare complications of uterine leiomyoma.We report a case of postmenopausal woman who presented with acute abdomen found to have intraleiomyoma hemorrhage, perforation, and hemoperitoneum.Our case also illustrates the computed tomography findings of such complications of uterine leiomyoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Medical Imaging, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.

ABSTRACT
Spontaneous intraleiomyoma hemorrhage, perforation, and hemoperitoneum are very rare complications of uterine leiomyoma. We report a case of postmenopausal woman who presented with acute abdomen found to have intraleiomyoma hemorrhage, perforation, and hemoperitoneum. Our case also illustrates the computed tomography findings of such complications of uterine leiomyoma.

No MeSH data available.


Related in: MedlinePlus

Post contrast sagittal reformatted computed tomography image showing heterogeneous pelvic mass “arrow” and high attenuation area inside it “arrow head,” suggesting active contrast extravasation
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Figure 3: Post contrast sagittal reformatted computed tomography image showing heterogeneous pelvic mass “arrow” and high attenuation area inside it “arrow head,” suggesting active contrast extravasation

Mentions: A 55-year-old multiparous postmenopausal woman presented to our emergency department with acute sudden lower abdominal pain for 2 h associated with dizziness. She denied trauma or vaginal bleeding and has no other associated symptoms. Her last menstrual period was 1 year back. Her medical history is significant for uterine fibroids only. On general examination, she had mild pallor. Her vital signs were stable. Abdominal examination revealed distension of lower abdomen with diffuse tenderness and guarding. A firm tender mass was felt arising from the pelvis. Her lab results were within normal limits except hemoglobin level was 10.4 g/dL. CT scan of abdomen and pelvis with intravenous contrast was performed which revealed a large uterine mass arising from the fundus with heterogeneous appearance and active contrast extravasation inside it [Figures 1 and 2]. It also showed an evidence of perforation at the fundus and high density moderate-free fluid (hemoperitoneum) [Figures 3 and 4]. A repeated hemoglobin level after 2 h was 8.5 g/dL. Therefore, two packed red blood cells were given and the patient was taken emergently to operating room. Laparotomy was done and revealed enlarged uterus with fundal perforation and clot and tissue coming out from the perforation site as well as about 1 L of hemoperitoneum. A total hysterectomy with bilateral salpingo-oophorectomy was performed. The patient recovered after surgery with uneventful postoperative course and discharged home.


Uterine leiomyoma with spontaneous intraleiomyoma hemorrhage, perforation, and hemoperitoneum in postmenopausal woman: Computed tomography diagnosis.

Alharbi SR - Avicenna J Med (2013)

Post contrast sagittal reformatted computed tomography image showing heterogeneous pelvic mass “arrow” and high attenuation area inside it “arrow head,” suggesting active contrast extravasation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3818784&req=5

Figure 3: Post contrast sagittal reformatted computed tomography image showing heterogeneous pelvic mass “arrow” and high attenuation area inside it “arrow head,” suggesting active contrast extravasation
Mentions: A 55-year-old multiparous postmenopausal woman presented to our emergency department with acute sudden lower abdominal pain for 2 h associated with dizziness. She denied trauma or vaginal bleeding and has no other associated symptoms. Her last menstrual period was 1 year back. Her medical history is significant for uterine fibroids only. On general examination, she had mild pallor. Her vital signs were stable. Abdominal examination revealed distension of lower abdomen with diffuse tenderness and guarding. A firm tender mass was felt arising from the pelvis. Her lab results were within normal limits except hemoglobin level was 10.4 g/dL. CT scan of abdomen and pelvis with intravenous contrast was performed which revealed a large uterine mass arising from the fundus with heterogeneous appearance and active contrast extravasation inside it [Figures 1 and 2]. It also showed an evidence of perforation at the fundus and high density moderate-free fluid (hemoperitoneum) [Figures 3 and 4]. A repeated hemoglobin level after 2 h was 8.5 g/dL. Therefore, two packed red blood cells were given and the patient was taken emergently to operating room. Laparotomy was done and revealed enlarged uterus with fundal perforation and clot and tissue coming out from the perforation site as well as about 1 L of hemoperitoneum. A total hysterectomy with bilateral salpingo-oophorectomy was performed. The patient recovered after surgery with uneventful postoperative course and discharged home.

Bottom Line: Spontaneous intraleiomyoma hemorrhage, perforation, and hemoperitoneum are very rare complications of uterine leiomyoma.We report a case of postmenopausal woman who presented with acute abdomen found to have intraleiomyoma hemorrhage, perforation, and hemoperitoneum.Our case also illustrates the computed tomography findings of such complications of uterine leiomyoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Medical Imaging, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.

ABSTRACT
Spontaneous intraleiomyoma hemorrhage, perforation, and hemoperitoneum are very rare complications of uterine leiomyoma. We report a case of postmenopausal woman who presented with acute abdomen found to have intraleiomyoma hemorrhage, perforation, and hemoperitoneum. Our case also illustrates the computed tomography findings of such complications of uterine leiomyoma.

No MeSH data available.


Related in: MedlinePlus