Massive hemoperitoneum from a bleeding uterine fibroid: Exploratory laparotomy myomectomy plus peritoneal irrigation

Introduction: Uterine fibroid is the most common benign gynaecological tumour in women of reproductive age, with a significant impact on the quality of life, economy, morbidity and sometimes mortality of affected women. The prevalence of uterine fibroids is notably higher in Black women compared to other racial backgrounds. It is estimated that fibroids are present in 60-80% of Black women compared to 30-40% in white women of reproductive age. This case is reported due to the unusual presentation of symptomatic uterine fibroid with haemoperitoneum. Case Summary: A case of symptomatic uterine fibroid with haemoperitoneum is presented. The patient presented with progressive lower abdominal swelling, excessive menstrual flow and Dizziness. She had an exploratory laparotomy, myomectomy plus peritoneal irrigation on account of haemoperitonium following a ruptured vessel on a fibroid. OUTCOME: The patient was managed successfully, had an uneventful postoperative period and follow-up visit. Conclusion: Spontaneous rupture of a vessel over a fibroid is a rare cause of hemoperitoneum. This condition can be life-threatening and should be borne in mind in any woman with fibroids presenting with an acute abdomen and signs of blood loss. Emergency laparotomy is recommended to arrest haemorrhage and establish the diagnosis.