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Intratumor Hemorrhage in Pedunculated Subserosal Leiomyoma Mimic Intraabdominal Bleeding: A case report |
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| รหัสดีโอไอ | |
| Creator | Lunthaporn Puttanavijarn |
| Title | Intratumor Hemorrhage in Pedunculated Subserosal Leiomyoma Mimic Intraabdominal Bleeding: A case report |
| Contributor | Saranya Chanpanitkitchot |
| Publisher | PIMDEE Co., Ltd. |
| Publication Year | 2568 |
| Journal Title | Thai Journal of Obstetrics and Gynaecology |
| Journal Vol. | 33 |
| Journal No. | 1 |
| Page no. | 82-86 |
| Keyword | intraabdominal bleeding, subserous leiomyoma, intratumor hemorrhage |
| URL Website | https://tci-thaijo.org/index.php/tjog/index |
| Website title | www.tci-thaijo.org |
| ISSN | 2673-0871 |
| Abstract | A 43-year-old para 2-0-0-2 woman with a history of three cesarean sections and tubal sterilization presented with chronic pelvic pain and heavy menstrual bleeding due to a large subserous myoma (16 x 9 cm). Two months after the initial presentation, she was admitted to the emergency department with acute abdominal pain and dyspnea. Physical examination revealed a distended abdomen, generalized tenderness, and a 24-week-sized mass. Laboratory tests indicated anemia with a hemoglobin level of 8.8 g/dl. Transabdominal ultrasound and contrast-enhanced computed tomography (CT) identified significant free fluid in the abdominal cavity and a large exophytic uterine mass, suspected to be a pedunculated subserous myoma. Exploratory laparotomy confirmed 500 mL of intraperitoneal serosanguinous fluid and a pedunculated subserous myoma measuring 27 cm, with evidence of intra-tumor hemorrhage. A total abdominal hysterectomy with bilateral salpingectomy was performed, with six units of packed red blood cells transfused. Pathological examination confirmed a subserous leiomyoma with hemorrhage and congestion. This case illustrated the rare complication of intra-tumor hemorrhage with intraperitoneal fluid reaction, typically presenting as acute abdominal pain. Emergency surgery was required for diagnosis and management, especially in the absence of trauma. |
