Venous Compression Secondary to Uterine Leiomyomas: A Unique Clinical Presentation
Speaker Credentials
MS-III
Speaker Credentials
BS
College
College of Allopathic Medicine
Medical Specialty
Internal Medicine
Format
Poster
Start Date
November 2024
End Date
November 2024
Track
4
Abstract
Introduction: Uterine leiomyomas are benign tumors of smooth muscle origin and are the most common pelvic tumors in women often diagnosed after menarche.1 Recent studies have shown a possible connection between uterine leiomyomas and venous thromboembolism usually due to direct vascular compression. Large bulky fibroid uterus may compress venous vessels leading to an increased risk of thromboembolic events.6 This case demonstrates a unique presentation of uterine fibroids in which the left iliac vein was compressed by a large uterine leiomyoma leading to a venous thromboembolic event. Case Presentation: We present the case of a 50-year-old female with no significant past medical history who was transferred to our facility for further management of deep vein thrombosis and pulmonary embolism. Review of systems was remarkable for left lower ankle swelling. Ultrasound venous duplex of left lower extremity showed deep vein thromboses. Computed tomography angiography of the chest revealed a pulmonary embolism. A pelvic ultrasound revealed enlarged uterus and multiple large fibroids. Computed tomography of the abdomen showed enlarged heterogenous myomatous uterus. Our concern for this patient was possible iliac vein compression in the setting of large uterine fibroids. Systemic anticoagulation was initiated with heparin for treatment of pulmonary embolism. A total abdominal hysterectomy and bilateral salpingectomy was completed the on hospital day five. Patient was discharged post operative day four. Discussion: This case shows the importance of early detection of uterine fibroid and prompt surgical management to reduce the risk of deep vein thromboses and other thrombotic sequalae.
Venous Compression Secondary to Uterine Leiomyomas: A Unique Clinical Presentation
Introduction: Uterine leiomyomas are benign tumors of smooth muscle origin and are the most common pelvic tumors in women often diagnosed after menarche.1 Recent studies have shown a possible connection between uterine leiomyomas and venous thromboembolism usually due to direct vascular compression. Large bulky fibroid uterus may compress venous vessels leading to an increased risk of thromboembolic events.6 This case demonstrates a unique presentation of uterine fibroids in which the left iliac vein was compressed by a large uterine leiomyoma leading to a venous thromboembolic event. Case Presentation: We present the case of a 50-year-old female with no significant past medical history who was transferred to our facility for further management of deep vein thrombosis and pulmonary embolism. Review of systems was remarkable for left lower ankle swelling. Ultrasound venous duplex of left lower extremity showed deep vein thromboses. Computed tomography angiography of the chest revealed a pulmonary embolism. A pelvic ultrasound revealed enlarged uterus and multiple large fibroids. Computed tomography of the abdomen showed enlarged heterogenous myomatous uterus. Our concern for this patient was possible iliac vein compression in the setting of large uterine fibroids. Systemic anticoagulation was initiated with heparin for treatment of pulmonary embolism. A total abdominal hysterectomy and bilateral salpingectomy was completed the on hospital day five. Patient was discharged post operative day four. Discussion: This case shows the importance of early detection of uterine fibroid and prompt surgical management to reduce the risk of deep vein thromboses and other thrombotic sequalae.