Rupture of uterine vessel by twisted fibroid causing intra-abdominal hemorrhage

The presence of free blood in the peritoneal cavity, encountered at operation, usually arises from a ruptured corpus hemorrhagicum, a bleeding peptic ulcer, or an ectopic pregnancy. Less frequently blood-tinged fluid is seen in mesenteric thrombosis, acute pancreatitis or a perforated chocolate ovarian cyst. An uncommon surgical experience is to find intraperitoneal hemorrhage from bleeding vessels of a uterine leiomyoma. A patient was recently treated by us after entering the hospital for an emergency operation. At the time of surgical intervention, free blood in the peritoneal cavity was found arising from a spurting vessel in the base of a twisted uterine fibroid. In view of the scarcity of this entity, we should like to report the case in question. REPORT OF CASEHistory.— N. D., a woman aged 39, was admitted to St. Peter's Hospital Dec. 30, 1948. Menses were regular, with occasional backache. The last menstrual period was