Massive Abdomen Hemoperitoneum Due to Rupture of Surface Vessels Over Uterine Fibroid: A Case Report

Uterine leiomyoma is benign mass found more commonly in young women at reproductive age and are rarely associated with hemoperitoneum. The direct cause of intraperitoneal bleeding due to fibroids is poorly understood. We report a case of a 38 years old women, nulliparous, presented to the emergency room with significant abdominal distention/pain and difficulty in breathing. The patient had no obvious history of any medical comorbidities. There were incidental findings of multiple large uterine fibroids largest 10x9 cm noted. The patient was hypotensive and tachycardia, she underwent emergency laparotomy, and there was an intra operative finding of massive intraperitoneal haemorrhage due to rupture of vessels on the surface of a subserous uterine fibroid. Rupture of leiomyoma surface vessel should be considered as one of differential diagnosis, when dealing with a case of intraperitoneal bleeding.