Intraluminal obstruction of distal ileum caused by a uterine leiomyoma

A 64-yr-old woman with nausea, vomiting, abdominal pain, and fecal impaction was found at autopsy to have an ileal obstruction by an intraluminal, calcified, spiculated mass. Examination revealed that this calcified mass had the features of a uterine leiomyoma. We postulate that a calcified, pedunculated uterine leiomyoma formed adhesions with the distal ileum, eroded through the ileal wall, and came to rest in the bowel lumen. Here, it was partially digested by the flow of intestinal contents, freed from its pedicle, and ultimately created an ileal obstruction. This rare complication of uterine leiomyomas has not been previously documented.