Abstract
Background: Intra-abdominal hemorrhage from uterine leiomyomas is rarely encountered. This is the first article to describe spontaneous intraperitoneal bleeding from a degenerating cytologically atypical leiomyoma that was pedunculated and appeared ovarian in origin on computed tomography. Case: We encountered a 45-year-old woman who presented with acute abdominal pain and syncope. She had an acute abdomen, intermittent bradycardia, decreasing hematocrit, and a pelvic mass with free fluid in the abdomen and pelvis. Laparotomy was performed and revealed a 5 × 6 × 5 cm degenerating pedunculated uterine mass that was ruptured and actively bleeding. After excision of the mass, the patient required blood transfusion but otherwise did well. Pathologic evaluation revealed an atypical leiomyoma. Conclusion: This case suggests that degenerating leiomyoma should be considered in patients presenting with intraperitoneal bleeding and a pelvic mass. (J GYNECOL SURG 21:21)
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