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Painless spontaneous haemoperitoneum secondary to a uterine leiomyoma/fibroid: unusual presentation of a life-threatening differential
  1. Chiamaka Maduanusi1,2,
  2. Sathiyaa Balachandran3,
  3. Sahathevan Sathiyathasan1 and
  4. Kazal Omar1
  1. 1Obstetrics and Gynaecology, Princess Royal University Hospital, Orpington, UK
  2. 2Obstetrics and Gynaecology, King's College Hospital NHS Foundation Trust, London, UK
  3. 3Obstetrics and Gynaecology, King's College London GKT School of Medical Education, London, UK
  1. Correspondence to Dr Chiamaka Maduanusi; c.maduanusi{at}


This is a case of a 47-year-old woman with a spontaneous haemoperitoneum secondary to uterine leiomyomas (fibroids), an important differential diagnosis in patients with uterine fibroids and hypovolaemic shock. Uterine fibroids are very common in women of reproductive age, yet little is taught about their potential to cause hypovolaemic shock. Although it is a rare complication, given the prevalence of fibroids, it is important to bear this life-threatening differential in mind to optimise the care for these women. Presentation typically involves abdominal pain, syncope, haemodynamic instability and an intra-abdominal mass. CT of the abdomen and pelvis can be helpful in identifying the source of the haemoperitoneum, but should not delay surgery, which is the definitive management.

  • obstetrics and gynaecology
  • reproductive medicine

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  • Contributors CM—wrote the case report, conducted the literature review and was involved in managing the patient. She is the guarantor. SB—interviewed the patient and summarised it in the patient’s reflective statement. SS and KO—reviewed and edited the case report, identified the case and were involved in managing the patient. The patient also kindly provided her reflection for the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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