1/18. hemoperitoneum from spontaneous bleeding of a uterine leiomyoma: a case report.Bleeding from uterine leiomyoma is a rare cause of hemoperitoneum. In most cases bleeding is a result of trauma or torsion. Spontaneous rupture of a superficial vein is extremely rare. Fewer than 100 cases have been reported. Our patient is a 44-year-old black woman who presented in the emergency room with acute onset of epigastric pain. Past medical and surgical history was not contributory except for a uterine "fibroid." In the emergency room, the patient's abdomen became diffusely tender. Her pregnancy test was negative, and the abdominal ultrasound showed fluid in the peritoneal cavity. The patient became hemodynamically unstable, and there was a significant drop of the hemoglobin/hematocrit. A surgical consultation was requested, and the patient underwent exploratory laparotomy. A subserosal uterine leiomyoma was found, with an actively bleeding vein on its dome. The leiomyoma was excised and 3 liters of blood and blood clots were evacuated from the peritoneal cavity. The patient was premenopausal and had a known leiomyoma. The clinical course was similar to that of previously reported cases. Although extremely rare, when there is no history of trauma, pregnancy, or other findings, spontaneous bleeding from uterine leiomyoma should be in the differential diagnosis. Emergent surgical intervention is recommended to establish the diagnosis and stop the hemorrhage.- - - - - - - - - - ranking = 1keywords = fibroid, leiomyoma (Clic here for more details about this article) |
2/18. Primary peritoneal pregnancy: a case report.A 22-year-old primipara using intrauterine contraceptive device was diagnosed to be in haemorrhagic shock due to acute ruptured ectopic pregnancy. At laparotomy, both tubes and ovaries were normal and products of conception were found to be implanted on the posterior surface of uterus near the attachment of right uterosacral ligament producing a haemoperitoneum of more than 2 l. This is the fourth case report of primary abdominal pregnancy associated with intrauterine contraceptive device (IUCD).- - - - - - - - - - ranking = 0.007719757106545keywords = uterus (Clic here for more details about this article) |
3/18. hemoperitoneum secondary to exophytic leiomyoma: report of a case.We report herein the case of a 63-year-old male with hemoperitoneum secondary to exogastric leiomyoma. The patient had been receiving anticoagulation therapy for a cerebral embolism and complained of sudden, severe abdominal pain. A sonogram and computed tomography scan showed an exogastric mass and massive ascites. A peritoneal puncture proved the presence of an intraperitoneal hemorrhage. An emergency laparotomy revealed a pedunculated bleeding tumor, thus confirming the preoperative diagnosis of a ruptured exogastric tumor. A microscopic analysis of the excised tumor demonstrated gastric leiomyoma. Other authors have reported hemoperitoneum secondary to gastric myogenic tumors, but no cases of leiomyomas could be found in the literature.- - - - - - - - - - ranking = 0.41209517015843keywords = leiomyoma (Clic here for more details about this article) |
4/18. Traumatic rupture of uterine fibroid: an uncommon cause of post traumatic haemoperitoneum.We report a case of traumatic rupture of uterine fibroid with a haemo-peritoneum in a non-gravid uterus of a 40 year old Nigerian woman whose life was saved by surgical intervention. Treatment consisted of subtotal hysterectomy. A high index of suspicion is required in order to enable prompt surgical intervention.- - - - - - - - - - ranking = 2.3585365203738keywords = fibroid, uterus (Clic here for more details about this article) |
5/18. placenta accreta associated with a ruptured pregnant rudimentary uterine horn. Case report and review of the literature.pregnancy in a rudimentary uterine horn is rare and is usually associated with fetal death and serious maternal morbidity and mortality. A case of pregnancy in a rudimentary uterine horn with rupture 14 weeks after last menstrual period and is complicated with placenta accreta is presented. The patient had signs and symptoms of massive hemoperitoneum. An emergency exploratory laparotomy revealed rupture of the gravid rudimentary horn of a bicornuate uterus. Histologic examination of the specimen showed that placenta was accreta. The relative literature is reviewed and the association of placenta accreta in such situations is pointed out.- - - - - - - - - - ranking = 0.007719757106545keywords = uterus (Clic here for more details about this article) |
6/18. Spontaneous subserosal venous rupture overlying a uterine leiomyoma. A case report.BACKGROUND: Patient age, parity and leiomyoma size are considered risks for venous rupture overlying a leiomyoma. CASE: A 28-year-old woman presented with abdominal pain and decreasing hematocrit from spontaneous rupture of a uterine leiomyoma vein. CONCLUSION: Congestion of a vein overlying a leiomyoma, irrespective of the patient's age or parity or size of the leiomyoma, is a risk factor for rupture.- - - - - - - - - - ranking = 0.52983664734655keywords = leiomyoma (Clic here for more details about this article) |
7/18. Nontraumatic massive hemoperitoneum from melanoma metastatic to the uterus.We have reported a case of nontraumatic massive hemoperitoneum caused by melanoma metastatic to the uterus that was readily managed with surgery. We believe this strategy provided effective palliation, improved quality of life and potentially prolonged survival for this patient.- - - - - - - - - - ranking = 0.038598785532725keywords = uterus (Clic here for more details about this article) |
8/18. Intraperitoneal haemorrhage secondary to perforation of uterine fibroid after cystic degeneration. Unusual CT findings resembling malignant pelvic tumor: case report.Intraperitoneal haemorrhage is a rare complication of myomatous uterus. We present a case of a 37-year-old white nullipara who presented in the emergency room with acute, lower-abdominal pain which reportedly started after riding over a bump on a motorcycle. On examination, the abdomen was diffusely tender, with moderate spasm and rebound tenderness in both iliac fossae. pregnancy test was negative. Computed tomography revealed a soft-tissue mass with cystic components and inhomogeneous appearance. Free fluid in the peritoneal cavity suggested ascites. The patient underwent an exploratory laparotomy. A ruptured, actively bleeding, subserosal, nonpedunculated, cystic degenerated uterine fibroid was found, as well as approximately two liters of free, bloodstained peritoneal fluid and clots. Subtotal hysterectomy without salpingo-oophorectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, definitive, preoperative diagnosis of a perforated, haemorrhaging, uterine fibroid is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.- - - - - - - - - - ranking = 2.8286998730272keywords = fibroid, uterus (Clic here for more details about this article) |
9/18. Internal hemorrhage caused by a twisted malignant ovarian dysgerminoma: ultrasonographic findings of a rare case and review of the literature.PURPOSE: Ovarian cancer presents as an acute abdomen very rarely. The purpose of the study is the description of a right ovarian malignant dysgerminoma presenting as an abdominal emergency. CASE: A 16-year-old white female presented with acute abdominal pain in the right iliac fossa. On physical examination the abdomen was acute and a mass in the right lower abdomen was palpated. The patient was sexually active and bimanual gynecological examination revealed the presence of a large lobulated solid tumor in the position of the right adnexa. Ultrasound examination showed the presence of a large, multilobulated, heterogeneous, predominantly solid pelvic mass. color flow imaging showed intratumoral flow signals. The uterus and the left ovary had normal size and echo-texture. Fluid was found in the cul-de-sac and in Morisson's space. An immediate exploratory laparotomy exposed the presence of a twisted right ovarian mass and intraperitoneal hemorrhage. A superficial tumoral vessel actively bleeding was seen. Peritoneal fluid was obtained for cytology. The intra-abdominal hemorrhage ceased when the ovarian pedicle was clamped. The patient underwent right salpingo-oophorectomy and biopsy of the omentum. Pathologic analysis revealed a malignant dysgerminoma of the right ovary, expanding to the mesosalpinx. Cytology was positive for malignancy. Postoperative CT scan of the upper and lower abdomen was negative. The patient was assigned to FIGO Stage IIC and referred for platinum-based chemotherapy. CONCLUSION: Ovarian malignant dysgerminoma may present as an acute abdomen because of torsion, passive blood congestion, rupture of superficial tumoral vessels and subsequent intra-abdominal hemorrhage. Ovarian dysgerminoma should be part of the differential diagnosis in a young woman with acute surgical abdomen and a solid heterogeneous pelvic mass detected by ultrasonographic scan.- - - - - - - - - - ranking = 0.007719757106545keywords = uterus (Clic here for more details about this article) |
10/18. Placenta percreta causing rupture of an unscarred uterus at the end of the first trimester of pregnancy: case report.Reports on placenta percreta in early pregnancy leading to a spontaneous rupture of the uterus are rare. We report a case of this potentially life-threatening complication in the 14th week of pregnancy in an otherwise healthy woman who underwent a manual extraction of the placenta during a previous delivery but who had no history of severe pathology that could have potentially resulted in uterine damage. The occurrence of severe abdominal pain and the presence of a large quantity of free fluid in the abdomen necessitated an emergency laparotomy, revealing a haemoperitoneum due to rupture of the uterus, which was followed by a hysterectomy. This case demonstrates that in patients with a history of placenta accreta and subsequent manual extraction of the placenta, a close investigation of the uterine wall and placentation should be performed in the first trimester in order to anticipate a placenta percreta.- - - - - - - - - - ranking = 0.04631854263927keywords = uterus (Clic here for more details about this article) |
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