腹腔鏡手術が有用であった子宮漿膜下筋腫の自然出血により腹腔内出血を生じた２症例

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Introduction: Hemoperitoneum due to spontaneous bleeding of uterine leiomyoma, is rare and is difficult to diagnose preoperatively. Additionally, there are few reports of laparoscopic treatment. Here, we report two patients with hemoperitoneum due to spontaneous bleeding of uterine leiomyoma who underwent successful laparoscopic surgery.

Case 1: A 31-year-old nulliparous woman with dizziness and abdominal pain was brought to the emergency department. Abdominal imaging revealed intra-abdominal masses and ascites. Emergency laparoscopic surgery identified bleeding from a subserosal uterine leiomyoma. The patient was successfully treated with laparoscopic myomectomy.

Case 2: A 43-year-old nulliparous woman visited a local doctor for abdominal pain. A few hours later, the patient developed hemorrhagic shock and was transported to our emergency room. Abdominal imaging revealed uterine fibroids and intraperitoneal bleeding. Emergency laparoscopic surgery identified spontaneous bleeding from a subserosal uterine leiomyoma, and laparoscopic uterine myomectomy was performed.

Conclusion: Although rare, spontaneous bleeding due to uterine fibroids can cause hemorrhagic shock, which is a lifethreatening condition. Since it is difficult to preoperatively diagnose hemoperitoneum secondary to bleeding of uterine leiomyoma, laparoscopic surgery is useful for its diagnosis and treatment if the patient is in stable condition.