A rare case of life threatening non-obstetric-non-traumatic vulvar-vaginal haematoma secondary to suspected spontaneous rupture of the right pudendal artery: surgical management in a reference hospital in Southern Nigeria

Authors

  • Innocent Okafor Eze Department of Obstetrics and Gynaecology, Nigerian Navy Reference Hospital, Ojo Lagos, Nigeria
  • Noble Chidiebere Anyanyu Department of General Surgery, Nigerian Navy Reference Hospital, Ojo Lagos, Nigeria
  • Ugochi Ogbonneya Nzeribe-Abangwu Department of Obstetrics and Gynaecology, Nigerian Navy Reference Hospital, Ojo Lagos, Nigeria
  • Victor Cletus Igboezue Department of Radiology, Nigerian Navy Reference Hospital, Ojo Lagos, Nigeria
  • Rufai Muhammed Department of Radiology, Nigerian Navy Reference Hospital, Ojo Lagos, Nigeria
  • David Ugonna Uzoho Department of Obstetrics and Gynaecology, Nigerian Navy Reference Hospital, Ojo Lagos, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20233649

Keywords:

Vulvar haematoma, Non-obstetrics-non-traumatic vulvar-vaginal haematoma, Pudendal artery rupture

Abstract

Vulvar haematoma due to obstetrics and traumatic causes have been reported. However, non-obstetrics-non-traumatic vulvar-vaginal haematoma is very rare yet could be life threatening. Good management and outcome may be challenged by low index of suspicion, inexperience and lack of standard guideline for care. We report a rare case of life threatening non-obstetric-non-traumatic vulvar-vaginal haematoma secondary to suspected spontaneous rupture of the right pudendal artery in a 35-year-old woman which presented as emergency with diagnostic challenges and was successfully surgically managed. This report draws attention of clinicians to this rare but important clinical scenario which can present with diagnostic challenges. It further highlights different approaches to treatment but emphasizes surgical treatment as key to quick recovery with lesser morbidities.

References

Hong HR. A case of vulvar haematoma with rupture of the pudendal artery. Obstet Gynecol Sci 2014; 57(2):168-71.

Eleanor E, Philip D, Nathan L. Vulvar haematoma secondary to spontaneous rupture of the internal iliac artery: clinical review. Am J Obstet Gynecol. 2009;12: 13-8.

Virgili A, Bianchi A, Mollica G, Corazza M. Serious hematoma of the vulva from a bicycle accident: a case report. J Reprod Med. 2000;45:662-4.

Ridgway L. Puerperal emergency: vaginal and vulvar hematomas. Obstet Gynecol Clin North Am. 1995; 22:275.

Mangwi AA. Non-obstetric vulva haematomas in a low resource setting: two case reports. Pan Afr Med J. 2019;33:314.

Awoleke JO, Ipinnimo OM. Vulvovaginal infralevator haematoma mimicking the Second Stage of Labour. Case Rep Obstet Gynecol. 2017;2017:806.

Eze IO, Salihu MJ, Innoeze CU, Elegbua CO, Afolayan ST, Adaji JA, et al. Consensual coital laceration of the posterior vaginal fornix with hemorrhagic shock in a teenage girl: diagnostic and management challenges. Afrimed J. 2022;8(1):34-7.

Rabinerson D, Fradin Z, Zeidman A, Horowitz E. Vulvar hematoma after cunnilingus in a teenager with essential thrombocythemia: a case report. J Reprod Med. 2007;52:458-9.

Mara LA, Estrella HH, Sandra BA, María José DS. Non-obstetric traumatic vulvar hematoma: Conservative or surgical approach? A case report. Case Rep Women Health. 2019;22:109.

Sherer DM, Stimphil R, Hellmann M, Abdelmalek E, Zinn H, Abulafia O. Transperineal sonography of a large vulvar haematoma following blunt perineal trauma. J Clin Ultrasound. 2006;34(6):309-12.

Downloads

Published

2023-11-28

Issue

Section

Case Reports