Hypovolemic shock and Hemoperitoneum from Spontaneous Avulsion of a Uterine Leiomyoma
39 year old female with acute arterial extravasation from spontaneous avulsion of a pedunculated leiomyoma confirmed intraoperatively. Hemoperitoneum with hypovolemic shock from avulsion of a subserosal leiomyoma is a rare but highly fatal condition that can occur spontaneously or as a result of trauma. We report a case of hemoperitoneum and hypovolemic shock secondary to a bleeding leiomyoma detected via CT scan in a patient that presented with abdominal pain and became hemodynamically unstable in the emergency department. Sonographic images (fig 4) obtained for pelvic pain two years prior show the subserosal fibroid with a vascular pedicle.