Positive Seatbelt Sign with Avulsed Leiomyoma following Motor Vehicle Accident Leading to Hemoperitoneum
A positive seatbelt sign following a motor vehicle accident is associated with an increased risk of intra-abdominal injury and hemoperitoneum. Injury to the uterus in reproductive-age women can also occur. In this report, we describe a 29-year-old nulligravida female who presented to the emergency r...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2018-01-01
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| Series: | Case Reports in Emergency Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/4251408 |
| Summary: | A positive seatbelt sign following a motor vehicle accident is associated with an increased risk of intra-abdominal injury and hemoperitoneum. Injury to the uterus in reproductive-age women can also occur. In this report, we describe a 29-year-old nulligravida female who presented to the emergency room following a motor vehicle accident at freeway speeds. A positive seatbelt sign was noted, and a focused assessment with sonography for trauma revealed hemoperitoneum with an incidental finding of uterine leiomyomata. Upon exploratory laparotomy, a free-floating intraperitoneal mass was identified as an avulsed uterine leiomyoma. A uterine laceration containing a subserosal leiomyoma was also identified. The gynecological team was consulted, and a myomectomy of the subserosal leiomyoma followed by a closure of the uterine laceration was performed. The patient was transfused with a total of three units of packed red blood cells and two units of fresh frozen plasma. The postoperative course was without major complication. A positive seatbelt sign and hemoperitoneum in a reproductive-age woman with leiomyomata should increase the clinical suspicion for uterine injury and decrease the threshold for obtaining a gynecological consultation. |
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| ISSN: | 2090-648X 2090-6498 |