Case of Hemorrhagic Shock Due to Superficial Vascular Disruption of Uterine Leiomyoma

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  • 子宮筋腫の表在血管破綻により出血性ショックに陥った1例
  • シキュウ キンシュ ノ ヒョウザイケッカン ハタン ニ ヨリ シュッケツセイ ショック ニ オチイッタ 1レイ

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Abstract

<p>We report a rare case of hemorrhagic shock with intraperitoneal hemorrhage due to a ruptured superficial blood vessel on the surface of a uterine leiomyoma. A 40-year-old female patient was transported to our hospital complaining of lower abdominal pain, which worsened on the day after menstruation. Her vital signs were unstable, with a blood pressure of 75/50 mm Hg and heart rate of 110 bpm. After her hemodynamic status improved with rapid fluid infusion, we performed computed tomographic (CT) examination. Abdominal contrast-enhanced CT showed intra-abdominal bleeding and a large tumor in the uterus. Laparotomy was performed since the patient was diagnosed as being in hemorrhagic shock at the time of transportation. Intraoperative findings revealed bloody ascites and bleeding from a blood vessel on the surface of the uterine leiomyoma. Uterine myomectomy was performed, and the postoperative course was good. The patient was discharged on the 8th postoperative day. While intraperitoneal bleeding due to uterine leiomyoma is rare, it can have serious consequences, and the condition should be considered in the differential diagnosis of disease for intra-abdominal bleeding in woman.</p>

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