Hypovolaemic shock due to intra-abdominal haemorrhage from multiple uterine fibroids

BMJ Case Rep. 2021 May 28;14(5):e241782. doi: 10.1136/bcr-2021-241782.

Abstract

Intra-abdominal bleeding due to uterine fibroids is extremely rare, and preoperative diagnosis is difficult. Herein, we report a case of preoperatively diagnosed hypovolaemic shock due to intra-abdominal haemorrhage, in which fatal sequelae were prevented. A 46-year-old non-pregnant woman was brought to the hospital with a sudden-onset lower abdominal pain. On admission, she was in shock, and abdominal CT showed severe intra-abdominal haemorrhage. Since bleeding from uterine fibroids was suspected, an emergency simple total hysterectomy was performed, and her condition became stable after the operation. Intra-abdominal haemorrhage with hypovolaemic shock requires prompt surgical intervention. Although it occurs very rarely due to bleeding from uterine fibroids, imaging shows large fibroids; if the patient is not pregnant, bleeding from the fibroids should be considered.

Keywords: general surgery; gynaecology and fertility; obstetrics.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Hemoperitoneum / diagnostic imaging
  • Hemoperitoneum / etiology
  • Hemoperitoneum / surgery
  • Humans
  • Hysterectomy
  • Leiomyoma* / complications
  • Leiomyoma* / diagnostic imaging
  • Leiomyoma* / surgery
  • Middle Aged
  • Pregnancy
  • Shock* / etiology
  • Uterus