Hemoperitoneum Caused by Spontaneous Rupture of Uterine Leiomyoma in a Perimenopausal Woman

Uterine fibroid, or leiomyoma, is a common benign neoplasm in women, but serious complications are rarely reported. We present the case of a 48-year-old woman with acute onset of abdominal pain. She was hemodynamically unstable, and computed tomography revealed abundant fluid collection in the peritoneal cavity, suggesting hemoperitoneum. During emergency exploratory laparotomy, the subserosal vein overlying a uterine fibroid was identified as the source of bleeding. Hemostasis was accomplished with fibroid excision. Spontaneous hemorrhage originating from a uterine fibroid is extremely rare, but may lead to life-threatening conditions. Therefore, in female patients with acute abdominal pain and hemoperitoneum, uterine fibroid may be a potential etiology and emergency exploratory laparotomy should be considered.

Hemoperitoneum Caused by Spontaneous Rupture of Uterine Leiomyoma in a Perimenopausal Woman

Uterine fibroid, or leiomyoma, is a common benign neoplasm in women, but serious complications are rarely reported. We present the case of a 48-year-old woman with acute onset of abdominal pain. She was hemodynamically unstable, and computed tomography revealed abundant fluid collection in the peritoneal cavity, suggesting hemoperitoneum. During emergency exploratory laparotomy, the subserosal vein overlying a uterine fibroid was identified as the source of bleeding. Hemostasis was accomplished with fibroid excision. Spontaneous hemorrhage originating from a uterine fibroid is extremely rare, but may lead to life-threatening conditions. Therefore, in female patients with acute abdominal pain and hemoperitoneum, uterine fibroid may be a potential etiology and emergency exploratory laparotomy should be considered.

Influence of Supplementary Vitamin D on Bone Mineral Density When Used in Combination with Selective Estrogen Receptor Modulators

OBJECTIVES: Vitamin D is regarded as one of the major nutrients that significantly influence bone metabolism. This study aims to look at the effect of supplementary vitamin D on bone mineral density (BMD) in female osteoporosis patients. METHODS: The retrospective hospital record review was performed on 282 patients who were diagnosed with osteoporosis and treated with selective estrogen receptor modulators (SERMs) between January 2015 and December 2016. Of these patients, 151 were treated with SERMs only while 131 were treated using both SERMs and vitamin D supplements. The BMD and any occurrence of osteoporotic fracture episode were investigated after one year. The result of two groups was compared to find the significance of vitamin D. RESULTS: Overall, improvement in BMD score was observed in 76% of the patients. The BMD of the SERMs only group improved by 3% in spine and 1% in the hip while that of the SERMs with vitamin D group improved by 6% and 1% respectively. Statistical significance was noticed in the spine only. One distal radius fracture and one single level vertebral fracture occurred in patients of SERMs group while two distal radius fractures occurred in SERMs with vitamin D group. There was no occurrence of around hip fracture in both groups. CONCLUSION: The result of the current study suggests that additional vitamin D may have some additive effect on improving BMD of the spine. Further study with the larger study population and the extended study period is recommended.

Breast diseases during pregnancy and lactation

Breast is a typical female sexual physiologic organ that is influenced by steroid hormone from menarche until menopause. Therefore various diseases can be developed by continuous action of estrogen and progesterone. Breast diseases are mainly categorized as benign and malignant. It is very important to distinguish the malignancy from breast diseases. However, it is very difficult to diagnose malignancy in pregnant and lactating women even though the same breast diseases took place. Therefore, we will review breast diseases such as breast carcinoma during pregnancy and lactation.

Change of Bone Mineral Density after One-year Alendronate Treatment in Premenopausal Women with Low Bone Density / 대한골다공증학회지

OBJECTIVES: To evaluate the efficacy of alendronate for premenopausal women with low bone density not resulted from secondary causes. MATERIALS AND METHODS: Forty thee women who was diagnosed low bone mineral density (BMD) before menopause were included. All patients were evaluated by history taking, physical examination, and laboratory investigation to rule out underlying secondary causes of osteoporosis. They were randomized into two groups: Group I was administered oral alendronate 70 mg per week and Group II was not. All the participants received calcium carbonate 1,250 mg and cholecalciferol 1,000 IU daily. Bone mineral density by dual energy X-ray absorptiometry was measured before and after 1 year of treatment. RESULTS: At baseline, there were no significant differences among the two groups in patient's age, body mass index (BMI), and BMD. After 1 year of treatment, Group I showed significant increase in BMD. CONCLUSIONS: In premenopausal women with low BMD in the absence of secondary causes for osteoporosis, alendronate treatment for 1 year may increase BMD. We suggest that management of low bone density in the premenopausal women without secondary causes should be considered.