Spontaneous rupture of a nongravid uterus: a case report

Rupture of a gravid uterus is a known complication of a cesarean hysterotomy. Uterine rupture of a nongravid uterus is usually caused by trauma, instrumentation, a pelvic mass, infection, or malignancy. Spontaneous rupture of a nongravid uterus is a rare event with only 4 cases reported in the English literature since 2011. This was the case of a healthy 52-year-old woman with a remote history of 2 cesarean deliveries and an endometrial ablation. The patient presented with severe right lower-quadrant pain. The hospital evaluation revealed a hemoperitoneum, a 5 cm endometrial complex or mass, and layering of blood product along the cesarean delivery scar. Exploration confirmed a spontaneous rupture of the previous hysterotomy. The patient was treated successfully with a total abdominal hysterectomy. Pathology report confirmed the uterine wall defect. Uterine rupture in the non-gravid uterus is a rare event. Presentation may be atypical but consistent with the diagnosis. Spontaneous uterine rupture should be considered in the nongravid patient with abdominal pain and a hemoperitoneum of unclear origin.