Emergency medicine
Jessica Ann Nathan; Valerie Chew Sze Yen; Nur Fazlin Ab Manan
Articles in Press, Corrected Proof, Available Online from 14 February 2023
Abstract
Objective: Spontaneous uterine artery rupture in a non-pregnant woman is an extremelyuncommon event. To date, there have only been a few cases. Patients often present withacute abdomen and are hemodynamically unstable.Case Presentation: A 42-year-old female presented with multiple episodes of syncopalattack ...
Read More
Objective: Spontaneous uterine artery rupture in a non-pregnant woman is an extremelyuncommon event. To date, there have only been a few cases. Patients often present withacute abdomen and are hemodynamically unstable.Case Presentation: A 42-year-old female presented with multiple episodes of syncopalattack associated with vomiting and generalized abdominal pain. Upon arrival, she washypotensive which required aggressive fluid resuscitation with crystalloids and bloodproducts. Urine pregnancy test was negative. In addition, ultrasound scan showedfree fluid in the abdomen mainly at the splenorenal area and organized clots aroundthe uterus. Computed tomography of the Abdomen revealed a moderate amount ofhemoperitoneum with hypodense clots at the left para-colic gutter and pelvis. Sheunderwent an exploratory laparotomy and intraoperatively noted bleeding from leftuterine artery with 1.2 L of hemoperitoneum with no other abnormalities detected.Intraoperatively, there was an estimated 5 L blood loss which required packed cell anddisseminated intravascular coagulation transfusion. Subsequently, the patient was sent tointensive care unit where she recovered well and was discharged home 5 days later.Conclusion: Spontaneous uterine artery rupture is an extremely rare occurrence with highmortality if there is failure to detect and intervene early