Spontaneous uterine artery rupture in a non-pregnant woman: A case report

Objective: Spontaneous uterine artery rupture in a non-pregnant woman is an extremely uncommon event. To date, there have only been a few cases. Patients often present with acute abdomen and are hemodynamically unstable. Case Presentation: A 42-year-old female presented with multiple episodes of syncopal attack associated with vomiting and generalized abdominal pain. Upon arrival, she was hypotensive which required aggressive fluid resuscitation with crystalloids and blood products. Urine pregnancy test was negative. In addition, ultrasound scan showed free fluid in the abdomen mainly at the splenorenal area and organized clots around the uterus. Computed tomography of the Abdomen revealed a moderate amount of hemoperitoneum with hypodense clots at the left para-colic gutter and pelvis. She underwent an exploratory laparotomy and intraoperatively noted bleeding from left uterine 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 and disseminated intravascular coagulation transfusion. Subsequently, the patient was sent to intensive care unit where she recovered well and was discharged home 5 days later. Conclusion: Spontaneous uterine artery rupture is an extremely rare occurrence with high mortality if there is failure to detect and intervene early.