Uterine leiomyoma-a common pathology with a rare life-threatening complication

Authors

  • Nuzhath Backer Subi Vihar Department of Obstetrics and Gynaecology, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India
  • Suja Mary Mani Department of Obstetrics and Gynaecology, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India
  • Vinitha Wills Department of Obstetrics and Gynaecology, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India
  • Susan Mathew Department of Obstetrics and Gynaecology, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243972

Keywords:

Uterine leiomyoma, Acute abdomen, Small intestinal obstruction

Abstract

Uterine leiomyoma, a common disease of women in reproductive age group may rarely present with a complication as an acute abdomen. We report such a case, a 40-year-old unmarried woman presented to our emergency department with acute abdominal pain, abdominal distension. Ultra sonogram abdomen revealed a large uterine leiomyoma causing small intestinal obstruction. The same was confirmed with abdominal imaging-X-ray erect and CECT. Managed by emergency exploratory laparotomy along with gastro surgical team. Small bowel obstructions are most commonly caused by postoperative adhesions, intestinal volvulus, malignancies or masses and strangulated hernias (together forming 90% of cases). The remaining are due to wide range of intrinsic and extrinsic bowel lesions. Small bowel obstruction is relatively a rare complication of uterine leiomyoma and occurring either as a result of compression of bowel loops by a large leiomyoma in the peritoneal cavity (as in this case), bowel loops incarceration between large pedunculated leiomyoma or bowel adhesions to the infarcted leiomyoma. Possibility of leiomyoma as the culprit causing intestinal obstruction to be considered especially in females with fibroid who present with an acute abdomen.

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References

Jonathan SB. Berek and Novak's Gynaecology. United States: 16th edition, Wolters Kluwer Health. 2019;227-50.

Hiralal K. DC Dutta's Textbook of Gynaecology. India: 6th edition, Jaypee Brothers Medical Publishers Pvt. Limited. 2014.221-30.

Sas D, Yang FJ, Agbayani N, Li SF. Small bowel obstruction caused by massive fibroids. Am J Emerg Med. 2021;41:263.e1-263.

Fontana R, Kamel PL. Small bowel obstruction associated with a leiomyomatous uterus. A case report and review of the literature. J Clin Gastroenterol. 1990;12(6):690-2.

Farooq R, Sahibole AS, Misiriyyah N, Ahmed H, Margossian H. Small Bowel Obstruction as a Complication of Uterine Fibroids: A Case Report. Cureus. 2023;15(3):e36902.

Rubinkiewicz M, Kenig J, Zbierska K, Lasek A. Autoamputated leiomyoma of the uterus as a rare cause of the mechanical bowel obstruction-report of a case. Pol Przegl Chir. 2014;86(7):341-4.

O'Connell PR, McCaskie AW, Sayers RD. Bailey and Love's Short Practice of Surgery-28th Edition, CRC Press. 2023;1280-9.

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Published

2024-12-27

How to Cite

Vihar, N. B. S., Mani, S. M., Wills, V., & Mathew, S. (2024). Uterine leiomyoma-a common pathology with a rare life-threatening complication. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(1), 287–290. https://doi.org/10.18203/2320-1770.ijrcog20243972

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Section

Case Reports