Leiomyomatous Degeneration evolving with Perfurative Acute Abdomen in a pregnant woman

Abstract

Objective: To report the case of a pregnant patient who developed acute perforating abdomen secondary to uterine leiomyomas with hyaline degeneration, scientifically reviewing the diagnosis and its interrelationships. Case detail: Pregnant patient, 35 years old, primigravidae, without prenatal care, seeks medical care complaining of diffuse lumbar and abdominal pain, nausea, vomiting and intestinal constipation. Laboratory tests showing leukocytosis, urine culture with infection, abdominal X-ray indicative of perforating acute abdomen. Antibiotic therapy and surgical approach with exploratory laparotomy were started, revealing degenerated subserosal myoma with adhesions in the small intestine and perforation of the intestinal loop. Myomectomy, enterectomy and ileostomy were performed, postoperative follow-up in the ICU and after hospital discharge in high-risk prenatal care. Final considerations: Uterine myomatosis is the most frequent benign neoplasm of the female reproductive tract, and can be classified as intramural, submucosal, subserosal. The subserosal can grow into the peritoneal cavity, which can cause compression of organs such as the intestine or bladder, causing torsion, ischemia and necrosis.