April 26th, 2018

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Laparoscopic Myomectomy for Hemoperitoneum from a Uterine Leiomyoma with Concomitant Tubal Abortion: A Case Report
Authors:  Janette Zuk Davison, M.D., Terri-Ann Bennett, M.D., and Ira M. Jaffe, D.O.
BACKGROUND: Ruptured ectopic pregnancy accounts for more cases of spontaneous hemoperitoneum than does the less frequently described acute bleeding from pedunculated uterine leiomyomata. When the latter does occur, management has consisted of laparotomy and either hemostatic suture or cauterization, myomectomy, or hysterectomy.

CASE: We report a case of hemoperitoneum secondary to active bleeding from a pedunculated uterine fibroid notable for the presence of a concomitant tubal abortion as well as for the minimally invasive, fertility-sparing management approach. The patient underwent an uncomplicated laparoscopic myomectomy and was discharged home on the first postoperative day.

CONCLUSION: Laparoscopic myomectomy is a safe, feasible alternative in the management of hemoperitoneum from pedunculated leiomyomata.
Keywords:  hemoperitoneum, laparoscopic myomectomy, laparoscopy, leiomyoma, uterine myomectomy
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