Case Report
Massive Intraperitoneal Hemorrhage and Hypovolemic Shock due to Rupture of a Coronary Vessel of a Uterine Leiomyoma: A Report of Two Cases
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JUN-ICHI AKAHIRA, KIYOSHI ITO, RYUJI NAKAMURA1 and AKIRA YAJIMA2
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Departments of Obstetrics and Gynecology and 1Surgery, Towada Municipal Central Hospital, Towada 034-0093, and 2Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai 980-8575
Intraperitoneal hemorrhage due to uterine leiomyoma is extremely rare. Recently, we encountered such two cases and herein describe them. Case 1 involved a 34-year-old, nulliparous woman referred to our hospital because of a sudden onset of shock while she was playing a softball game. She had a large abdominal tumor and a hemoperitoneum, and was diagnosed as having a ruptured ovarian tumor. Exploratory laparotomy showed a rupture of the coronary vein of a large uterine leiomyoma. The patient was treated with myomectomy and did well postoperatively. Case 2 involved a 44-year-old, multiparous woman referred to our hospital because of sudden onset of lower abdominal pain while defecating. She had a uterine leiomyoma and a hemoperitoneum, and was diagnosed as having a ruptured splenic artery. Exploratory laparotomy showed rupture of the coronary artery of a uterine leiomyoma. The patient was treated with total abdominal hysterectomy and did well postoperatively. These cases suggest that intraperitoneal hemorrhage associated with uterine leiomyoma, although rare, should be considered in women with hypovolemic shock and a large pelvic mass.
Key words---
uterine leiomyoma; uterine fibroid; intraperitoneal hemorrhage; hypovolemic shock
© 1998 Tohoku University Medical Press
Tohoku J. Exp. Med., 1998, 185, 217-222
Present address for Jun-ichi Akahira, Departments of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan.
For reprints request, contact J. Akahira at the address above.
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