ABSTRACT Spontaneous venous rupture overlying a uterine fibroid is a rare cause of hemoperitoneum. A 38-year-old woman presented to the emergency department with acute onset of abdominal pain. The ultrasound revealed multiple fibroids and free fluid in the peritoneum. There was a significant drop of the hemoglobin and hematocrit. The patient underwent emergent exploratory laparoscopy. A subserosal uterine leiomyoma was found, with a bleeding vein on its basis and massive hemoperitoneum. Laparoscopic myomectomy was successfully performed with local injection of vasopressin and intraoperative autologous blood transfusion. This case suggests that spontaneous intraperitoneal haemorrhage associated with uterine fibroids, although rare, should be considered in women with hypovolemic shock and a pelvic mass.
Cite this paper
Takeuchi, K. , Sugimoto, M. , Tsujino, T. and Nishino, R. (2012) Successful laparoscopic management of hemoperitoneum due to spontaneous venous rupture overlying a uterine fibroid. Open Journal of Obstetrics and Gynecology, 2, 164-166. doi: 10.4236/ojog.2012.22032.
 Danikas, D., Theodorou, S.J., Kotrotsios, J., Sills, C. and Cordero, P.E. (1999) Hemoperitoneum from spontaneous bleeding of a uterine leiomyoma: A case report. The American Journal of Surgery, 65, 1180-1182.
 Drutman, J. and Fruechte, D.M. (1992) Hemoperitoneum due to traumatic avulsion of a pedunculated uterine leiomyoma. American Journal of Roentgenology, 158, 1410.
 Estrade-Huchon, S., Bouhanna, P., Limot, O., Fauconnier, A. and Bader, G. (2010) Severe life-threatening hemoperitoneum from posttraumatic avulsion of a pedunculated uterine leiomyoma. Journal of the Minimally Invasive Gynecology, 17, 651-652.
 Mattison, D.R. and Yeh, S.Y. (1980) Hemoperitoneum from rupture of a uterine vein overlying a leiomyoma. American Journal of Obstetrics and Gynecology, 136, 415-416.
 Dahan, M.H. and Ahmadi, R. (2002) Spontaneous subserosal venous rupture overlying a uterine leiomyoma. A case report. The Journal of Reproductive Medicine, 47, 419-420.