Difficult diagnosis of hemoperitoneum in a patient with a pelvic mass of large size
| Autor: | Maria Chiara Sudano, Emanuele Cerruto, Carla Ettore, Michele Giulano La Greca, Giorgio La Greca |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
TC computed tomography Pelvic mass Uterus Computed tomography Case Report Varicous veins rupture 03 medical and health sciences 0302 clinical medicine Intraperitoneal hemorrhage medicine Hemoperitoneum Uterine myoma 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Myoma medicine.disease Surgery body regions medicine.anatomical_structure Radiology medicine.symptom business 030217 neurology & neurosurgery Large size |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Pelvic mass and hemoperitoneum. Introduction Intraperitoneal hemorrhage caused by a uterine myoma is rare (Tajima et al., 2015). Presentation of case A 47-year-old woman was admitted to the emergency room for worsening abdominal pain. Ultrasound revealed fluid filled almost the entire abdominal cavity as well as the presence of a mass of about 20 cm near the uterus. It was not easy to understand the nature of the fluid by ultrasound. It appeared to be ascites with a tumoral pelvic neoformation. On TC there was extravasation of contrast material, but the bleeding site was not identifiable. An emergency operation was performed. Bleeding was from a subserosalmyoma on the anterior wall of the uterus; myoma measured approximately 20 cm in maximum diameter. Pathological assessment of the resected specimen revealed bleeding from ruptured tortuous veins on a serosal-type uterine myoma. Discussion Spontaneous rupture of a vein or an artery overlying a myoma has been documented in English literature on the subject, although it is extremely rare (Tajima et al., 2015). Conclusion The differential diagnosis between ascites and hemoperitoneum is sometimes not easy. Ultrasound is a helpful instrument in expert hands to make a diagnosis of hemoperitoneum. The aid of other diagnostic methods as TC help the clinician to arrive at the correct diagnosis quickly. |
| Databáze: | OpenAIRE |
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