Massive hemoperitoneum in case of large subserosal fibroid- a rare case report

Yuvrajsingh Digvijaysingh Jadeja, Radha Shukla, Smruti Vaishnav, Molina Patel


Rupture of veins on the surface of uterine leiomyoma is an extremely uncommon gynaecological cause of haemoperitoneum. It is a life-threating emergency. In most cases, bleeding is a result of trauma or torsion. Here we report a case of massive intraperitoneal haemorrhage due to rupture of vessels on the surface of large sub-serous leiomyoma to stress on the fact that a differential diagnosis of rupture of surface vessels in a fibroid should be considered while dealing with a case of haemoperitoneum with pelvic masses


Fibroid, Haemoperitoneum, Sub serous, Superficial veins

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Marshall LM, Spiegelman D, Barbieri RL, Goldman MB, Manson JE, Colditz GA, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997;90:967-73.

Battery BW. Spontaneous haemoperitoneum complicating uterine fibromyoma. Aust N Z J Obstet Gynaecol. 1972;12:210-3.

Danikas D, Theodorou SJ, Kotrotsios J, Sills Cordero PE, Haemoperitoneium from spontaneous bleeding of a uterine leiomyoma: A case report Am Surg. 1999;65:1180-82.

Lotterman S. Massive hemoperitoneum resulting from spontaneous rupture of uterine leiomyoma. Am J Emerg Med. 2008;26:974.e1-2.

Shinde KK, Gavhane SP, Ghorpade N, Gupta K, Gangapurwala S. Massive hemoperitoneum due to rupture of surface veins of a uterine leiomyoma. Int J Biomed Adv Res. 2014;5(2):128-30.

Shapira A, Stars A. Massive intraperitoneal hemorrhage from ruptured subserous veins on the surface of uterine fibroid. N Engl J Med. 1932;207:827-9.

Manopunya M, Tongprasert F, Sukpan K, Tongsong T. Intra-leiomyoma massive hemorrhage after delivery. J Obstet Gynaecol Res. 2013;39:355-8.

Akahira J, Ito K, Nakamura R, Yajima A. Massive intraperitoneal hemorrhage and hypovolemic shock due to rupture of a coronary vessel of a uterine leiomyoma: a report of two cases. Tohoku J Exp Med. 1998;185(3):217-22.

Gulati N, Raman S, Srinivasan M, Bakour S. Rare gynaecological emergency: massive intraperitoneal haemorrhage from spontaneous rupture of a superficial vessel on a large leiomyoma. BMJ Case Rep. 2016.

Ihama Y, Miyazaki T, Fuke C. Haemoperitoneum due to rupture of a subserosal vein overlying a uterine leiomyoma. Am J Forensic Med Pathol. 2008;29(2):177-80.