| Autor: |
Kassegne I; Service de Chirurgie Générale et Viscérale, Centre Hospitalier Universitaire Sylvanus Olympio, BP: 57 Lomé, Togo.; Service de Gynécologie et Obstétrique, Clinique Biasa, BP: 2160 Lomé, Togo., Kolani K; Service de Gynécologie et Obstétrique, Clinique Biasa, BP: 2160 Lomé, Togo., Tchangai B; Service de Chirurgie Générale et Viscérale, Centre Hospitalier Universitaire Sylvanus Olympio, BP: 57 Lomé, Togo., Kanassoua K; Service de Chirurgie Générale et Viscérale, Centre Hospitalier Universitaire Sylvanus Olympio, BP: 57 Lomé, Togo., Adabra K; Service de Chirurgie Générale et Viscérale, Centre Hospitalier Universitaire Sylvanus Olympio, BP: 57 Lomé, Togo., Alassani F; Service de Chirurgie Générale et Viscérale, Centre Hospitalier Universitaire Sylvanus Olympio, BP: 57 Lomé, Togo., Amavi AK; Service de Chirurgie Générale et Viscérale, Centre Hospitalier Universitaire Sylvanus Olympio, BP: 57 Lomé, Togo., Dosseh EDJ; Service de Chirurgie Générale et Viscérale, Centre Hospitalier Universitaire Sylvanus Olympio, BP: 57 Lomé, Togo.; Service de Gynécologie et Obstétrique, Clinique Biasa, BP: 2160 Lomé, Togo. |
| Abstrakt: |
Massive hemoperitoneum from spontaneous bleeding of uterine myoma is an extremely rare condition, that needs urgent surgical exploration. We report a 40-year-old woman, admitted for acute onset of abdominal pain. Physical examination revealed hypovolemic shock. The hemoglobin level was of 5 g/dL. Ultrasonography revealed hemoperitoneum. Emergency surgical exploration was planned. There was hemoperitoneum of 3 L, uterine myomas with multiple subserous myomas, bleeding from superficial ruptured varice overlying the most largest subserous myoma, which measured 15 cm. Glove adapted as a tourniquet, was applied at the base of the uterus, and myomectomies were performed with removal of around twenty myomas. The postoperative course was uneventful. Myomectomies can be safely and effectively performed by using a tourniquet, for massive hemoperitoneum with precarious hemodynamic status due to subserous myoma bleeding, despite the number and the size of myomas. |
