Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography

Background. Spontaneous rupture of benign uterine fibroids is extremely rare and has been associated with fibroid degeneration. It can cause acute intraperitoneal bleeding requiring immediate surgical intervention. Case. A previously healthy 50-year-old, Caucasian, nullipara presented with syncope,...

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Main Authors: Angel Shan, Rahana Harjee, Patrick McLaughlin, Edward C. Jones, Mohamed A. Bedaiwy
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2020/5364165
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author Angel Shan
Rahana Harjee
Patrick McLaughlin
Edward C. Jones
Mohamed A. Bedaiwy
author_facet Angel Shan
Rahana Harjee
Patrick McLaughlin
Edward C. Jones
Mohamed A. Bedaiwy
author_sort Angel Shan
collection DOAJ
description Background. Spontaneous rupture of benign uterine fibroids is extremely rare and has been associated with fibroid degeneration. It can cause acute intraperitoneal bleeding requiring immediate surgical intervention. Case. A previously healthy 50-year-old, Caucasian, nullipara presented with syncope, hemodynamic instability, and an acute abdomen. Noncontrast computed tomography images showed a positive sentinel clot sign in the pelvis as well as a large uterine fibroid with internal hyperdense clot suggesting acute rupture. Urgent laparotomy and hysterectomy confirmed a ruptured, actively bleeding, uterine fibroid with final pathological diagnosis of a benign leiomyoma. Conclusion. Prompt diagnosis and emergency surgical intervention were necessary to control acute hemorrhage from a ruptured uterine fibroid. Noncontrast computed tomography is an important adjunct to contrast-enhanced computed tomography and was vital for diagnosis in this case.
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spelling doaj-art-ded9292d3f7d427e8a2ab81fac65fab22025-08-20T02:21:20ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922020-01-01202010.1155/2020/53641655364165Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed TomographyAngel Shan0Rahana Harjee1Patrick McLaughlin2Edward C. Jones3Mohamed A. Bedaiwy4Department of Obstetrics and Gynecology, Women’s Hospital of British Columbia, University of British Columbia, Vancouver, CanadaDepartment of Obstetrics and Gynecology, Women’s Hospital of British Columbia, University of British Columbia, Vancouver, CanadaDepartment of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, CanadaDepartment of Pathology, Vancouver General Hospital, University of British Columbia, Vancouver, CanadaDepartment of Obstetrics and Gynecology, Women’s Hospital of British Columbia, University of British Columbia, Vancouver, CanadaBackground. Spontaneous rupture of benign uterine fibroids is extremely rare and has been associated with fibroid degeneration. It can cause acute intraperitoneal bleeding requiring immediate surgical intervention. Case. A previously healthy 50-year-old, Caucasian, nullipara presented with syncope, hemodynamic instability, and an acute abdomen. Noncontrast computed tomography images showed a positive sentinel clot sign in the pelvis as well as a large uterine fibroid with internal hyperdense clot suggesting acute rupture. Urgent laparotomy and hysterectomy confirmed a ruptured, actively bleeding, uterine fibroid with final pathological diagnosis of a benign leiomyoma. Conclusion. Prompt diagnosis and emergency surgical intervention were necessary to control acute hemorrhage from a ruptured uterine fibroid. Noncontrast computed tomography is an important adjunct to contrast-enhanced computed tomography and was vital for diagnosis in this case.http://dx.doi.org/10.1155/2020/5364165
spellingShingle Angel Shan
Rahana Harjee
Patrick McLaughlin
Edward C. Jones
Mohamed A. Bedaiwy
Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography
Case Reports in Obstetrics and Gynecology
title Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography
title_full Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography
title_fullStr Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography
title_full_unstemmed Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography
title_short Spontaneous Rupture of Leiomyoma Diagnosed Preoperatively with Noncontrast Computed Tomography
title_sort spontaneous rupture of leiomyoma diagnosed preoperatively with noncontrast computed tomography
url http://dx.doi.org/10.1155/2020/5364165
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AT patrickmclaughlin spontaneousruptureofleiomyomadiagnosedpreoperativelywithnoncontrastcomputedtomography
AT edwardcjones spontaneousruptureofleiomyomadiagnosedpreoperativelywithnoncontrastcomputedtomography
AT mohamedabedaiwy spontaneousruptureofleiomyomadiagnosedpreoperativelywithnoncontrastcomputedtomography