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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 303-305    DOI: 10.31083/j.ceog.2020.02.5005
Case Report Previous articles | Next articles
Ruptured myometrial tumors as a cause of spontaneous hemoperitoneum
K. Sandal1, *(), I. Yetimoglu1, M. A. Sargin1, N. Tug1
1Clinic of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey
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Hemoperitoneum is a common cause of emergency surgery. Common gynecologic causes of hemoperitoneum include ruptured ectopic pregnancies, bleeding ovarian cysts, and very rarely, bleeding from uterine masses secondary to infarction and ulceration or ruptured superficial veins, secondary to increased intra-abdominal pressure. However, spontaneous bleeding of a uterine mass without any history of trauma, increased abdominal pressure, recent pregnancy, or menstruation is very rare. Herein the authors report two cases of acute abdomen secondary to spontaneous bleeding of a ruptured uterine smooth muscle tumor of unknown malignancy potential and endometrial stromal sarcoma. In the differential diagnosis of hemoperitoneum, uterine tumors should be considered as a potential site of the bleeding.

Key words:  Hemoperitoneum      Ruptured ectopic pregnancies      Uterine tumors     
Published:  15 April 2020     
*Corresponding Author(s):  K. Sandal     E-mail:

Cite this article: 

K. Sandal, I. Yetimoglu, M. A. Sargin, N. Tug. Ruptured myometrial tumors as a cause of spontaneous hemoperitoneum. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 303-305.

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Figure 1.  — a) MRI of Case 1 showing a 98×78×113-mm sized heterogenous mass originating from uterine fundus and continuing to the right adnexal area with mild contrast enhancement and diagnosed as STUMP on pathological examination. b) Surgical specimen of Case 2 showing a high-grade ESS which is bleeding from its vegetative surface.

[1] Danikas D., Theodorou S.J., Kotrotsis J., Sills C., Cordero P.E.: “Hemoperitoneum from spontaneous bleeding of a uterine leiomyoma: a case report”. Am. Surg., 1999, 65, 1180.
pmid: 10597071
[2] Deopuria R.H.: “Haemoperitoneum secondary to rupture of coronary veins on a fibroid uterus (Review)”. J. Obstet. Gynecol. India, 1970, 20, 409.
[3] Drutman J., Fruechte D.M.: “Hemoperitoneum due to traumatic avulsion of a pedunculated uterine leiomyoma”. AJR Am. J. Roentgenol., 1992, 158, 1410.
doi: 10.2214/ajr.158.6.1590170 pmid: 1590170
[4] Makar A.P., Meulyzer P.R., Vergote I.B., Schatteman E.A., Huyghe M.L., Meeuwis L.A.: “A case report of unusual complication of myomatous uterus in pregnancy: spontaneous perforation of myoma after red degeneration”. Eur J Obstet Gynecol Reprod Biol., 1989; 31:289-293.
doi: 10.1016/0028-2243(89)90166-4 pmid: 2753197
[5] Benson C., Miah A.B.: “Uterine sarcoma current perspectives”. Int. Womens Health, 2017, 9, 597.
[6] Saidi F., Constable J.D., Ulfelder H.: “Massive intraperitoneal hemorrhage due to uterine fibroids”. Am. J. Obstet. Gynecol., 1961, 82, 367.
pmid: 13745415
[7] Horowitz E., Dekel A., Feldberg D., Rabinerson D.: “Massive hemoperitoneum due to rupture of an artery overlying a uterine leiomyoma: a case report”. Acta Obstet. Gynecol. Scand., 2005, 84, 408.
pmid: 15762978
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