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Case Reports: Unusual presentation of more common disease/injury
Acute lower limb ischaemia secondary to aortic compression from uterine fibroid
  1. Siti Hajar Nawawi1,
  2. Wan Zulkafli Wan Ibrahim1,
  3. Mohd Mazri Yahya2,3 and
  4. Roziana Ramli1
  1. 1Ministry of Health Malaysia, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia
  2. 2Department of Surgery, KPJ Johor Specialist Hospital, Johor Bahru, Malaysia
  3. 3Department of Surgery, KPJ Healthcare University College, Johor Bahru, Malaysia
  1. Correspondence to Dr Roziana Ramli; drroziana{at}yahoo.com

Abstract

A woman in her early 50s with uncontrolled diabetes mellitus and a huge uterine fibroid presented to the emergency department with diabetic ketoacidosis and bilateral acute lower limb ischaemia. Vascular and advanced imaging studies confirmed distal aortic compression by a huge uterine fibroid, resulting in extensive lower limb arterial thrombosis. After resuscitation, the patient underwent emergency hysterectomy, thromboembolectomy and amputation of the right leg. She remained critically ill and died of fulminant sepsis and multiorgan failure 10 days later. This case reports the effects of external vascular compression by a large pelvic mass.

  • Reproductive medicine
  • Vascular surgery

https://doi.org/10.1136/bcr-2022-253129

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: SHN, WZWI, MMY, RR. The following authors gave final approval of the manuscript: SHN, WZWI, MMY, RR.

    • 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.