Torsion of a uterine leiomyoma - a rare cause of hemoperitoneum; a case report and review of the literature.

Abstract

Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications are very rare. Wepresent an unusual case of 38-year-old woman that came to the emergency department with acute abdominal pain. The ultrasoundrevealed hemoperitoneum, a uterus with two intramural fibroids and a tender inhomogeneous pelvic mass that seemsto connect with the uterus. Computer tomographic (CT) examination raised the suspicion of a degenerated fibroid and hemoperitoneum.Emergency laparotomy was performed: the hemoperitoneum was determined by a degenerated fundal subserosalfibroid. Myomectomy was subsequently carried out. Even though this condition is extremely rare, every clinician has to bearin mind that acute fibroid complications can be a potential cause of acute abdominal pain that requires immediate surgery. Theimagistic tools, ultrasound and CT are extremely helpful for the diagnosis.Due to its relative rarity in the second part of the article we have performed a review of the existing literature regardingthe acute complications of fibroid torsion.