Laparoscopic myomectomy for hemoperitoneum from a uterine leiomyoma with concomitant tubal abortion: a case report.
BACKGROUND
Ruptured ectopic pregnancy accounts for more cases of spontaneous hemoperitoneum than does the less frequently described acute bleeding from pedunculated uterine leiomyomata. When the latter does occur, management has consisted of laparotomy and either hemostatic suture or cauterization, myomectomy, or hysterectomy.


METHODS
We report a case of hemoperitoneum secondary to active bleeding from a pedunculated uterine fibroid notable for the presence of a concomitant tubal abortion as well as for the minimally invasive, fertility-sparing management approach. The patient underwent an uncomplicated laparoscopic myomectomy and was discharged home on the first postoperative day.


CONCLUSIONS
Laparoscopic myomectomy is a safe, feasible alternative in the management of hemoperitoneum from pedunculated leiomyomata.
Department of Obstetrics and Gynecology, New York University Langone Medical Center, 550 First Avenue, NBV-9E2, New York, NY 10016, USA. janette.z.davison@gmail.com
Janette Zuk
JZ
Davison
Terri-Ann
TA
Bennett
Ira M
IM
Jaffe
D000022:Abortion, Spontaneous / Q000601:surgery; D000328:Adult; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000000981:diagnostic imaging / Q000601:surgery*; D012422:Rupture, Spontaneous / Q000150:complications; D014463:Ultrasonography; D063186:Uterine Myomectomy / Q000379:methods; D014594:Uterine Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery