Rare postpartum ruptured degenerated fibroid: A case report. Issue 5 (2nd April 2014)

• Record Type: Journal Article
• Authors: Tan, Yiap L.; Naidu, Aruku
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 40:Issue 5(2014:May)
• Page Start: 1423
• Page End: 1425
• Publication Date: 2014-04-02
• Subjects: Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.12334
• Languages: English
• ISSNs: 1341-8076

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <p>Spontaneous rupture of uterine fibroid is rarely encountered. We present a case of a 31‐year‐old who presented with acute abdominal pain at 9 weeks postpartum. On examination, the abdomen had diffuse tenderness, with rebound tenderness in the suprapubic area and in both iliac fossae. On ultrasonography, a 12.7 × 8.6 × 8.9‐cm sized hyperechoic mass was visible on the posterior wall of the uterus. A large amount of fluid was visible in the paracolic gutters and the Pouch of Douglas (POD). The patient underwent an exploratory laparotomy. A ruptured, cystic degenerated uterine fibroid with active bleeding was found, as well as approximately half a liter of free, bloodstained peritoneal fluid and pus. Myomectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, preoperative diagnosis of a perforated, uterine fibroid with spontaneous intra‐abdominal hemorrhage is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life‐threatening condition.</p> </abstract>