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Ruptured angiomyolipoma, a novel entity for emergency physicians in the differential diagnosis of haemorrhagic shock in a female patient of reproductive age
  1. Abby Jo Sapadin1,
  2. Daniel Girzadas1,
  3. Darshika Chhabra2 and
  4. Tasneem Ahmed1
  1. 1Emergency Department, Advocate Christ Medical Center, Oak Lawn, Illinois, USA
  2. 2Nephrology, Advocate Christ Medical Center, Oak Lawn, Illinois, USA
  1. Correspondence to Dr Abby Jo Sapadin; abby.sapadin{at}


A woman in her 30s presented to the emergency department with acute onset, progressively worsening left-sided abdominal pain after exercise. She was found to be hypotensive and diaphoretic, with free intraperitoneal fluid detected on bedside point-of-care ultrasound. Resuscitation was initiated, a presumptive diagnosis of ruptured ectopic pregnancy was made, and obstetrics and gynaecology were consulted. Point-of-care urine pregnancy testing, however, was negative, and subsequent CT angiography of the patient’s abdomen revealed an angiomyolipoma (AML) with active haemorrhage. Ultimately, embolisation was performed in the interventional radiology suite, with improvement of patient haemodynamics. Ruptured AML is a rare, life-threatening condition that needs to be included in the differential diagnosis of haemorrhagic shock in female patients of reproductive age presenting to the emergency department.

  • Renal intervention
  • Acute renal failure
  • Interventional radiology
  • Emergency medicine
  • Resuscitation

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  • Contributors AJS, TA, DC and DG contributed to elements of the written case report. AJS obtained images to include with the case report from the patient’s medical record and complied and cited references for the case report. DG completed editing and included additional citations 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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