Background: Fibroids are the most common pelvic tumors in women; serious complications are rare but can be life-threatening.
Case presentation: We present a case report of a 38-year-old Persian woman with acute abdominal pain and a history of uterine fibroids. The patient refused to undergo a laparoscopic myomectomy. Her ultrasound examination revealed free fluid in the abdominal cavity, and her vital signs were indicative of vasogenic shock. A diagnostic laparoscopy was performed to identify and control the source of bleeding: 400 ml of blood and blood clots were removed. Active bleeding was seen from a vein overlying a subserosal myoma. A laparotomic myomectomy was performed, and the patient was discharged 3 days after surgery with no complications.
Conclusion: Surgeons should consider the possibility of this complication in women with acute abdominal pain and a history of uterine leiomyoma.
Keywords: Case report; Hemoperitoneum; Subserous myoma.