Complications threatening life due to unscientific treatment of uterine fibroids

The Ho Chi Minh City University of Medicine and Pharmacy Hospital (BV ĐHYD TPHCM) has just successfully treated a case of necrotic infection of a large uterine fibroid tumor, leading to severe generalized peritonitis, posing a life‑threatening risk to the patient. The cause of this severe infection and peritonitis originated from the patient being treated with the wrong method, which can even be considered unscientific and extremely dangerous at a private clinic, thereby losing the chance to become a mother.

This is the case of Ms. N.T.Q. (29 years old, residing in Bình Dương). Ms. Q. was admitted to the hospital in a condition of high fever, chills, rapid pulse, a distended and painful abdomen. The entire upper abdominal skin surface over the tumor was necrotic, infected, ulcerated, discharging thick yellow pus with a foul odor, and there were fistulous tracts from the skin surface into the abdominal cavity. After examination and necessary tests, the doctors determined that Ms. Q. had a very large uterine fibroid (about the size of a 7‑month‑old fetus) that was necrotic, infected, accompanied by severe generalized peritonitis.

The entire upper abdominal skin surface over the tumor is necrotic, infected, ulcerated, oozing foul‑smelling yellowish pus, and there are tracks from the skin surface into the abdominal cavity.

A year ago, Ms. Q. was diagnosed with uterine fibroids at a hospital in Ho Chi Minh City. She was scheduled for surgery but refused treatment because she was afraid of “cutting and stitching”. Afterwards, upon a friend's recommendation, Ms. Q. went to a private clinic in Binh Duong. There, she was advised and treated by the clinic staff by daily using a needle to directly pierce the tumor to draw blood out, helping

the tumor shrank. However, after 3 months of using this method, the tumor did not shrink but became larger. Ms. Q. began to feel fatigued, constantly having high fever, chills, abdominal pain, and it kept enlarging. The skin area pierced by the needle ulcerated, discharging fluid and pus causing pain. At this point, the “traditional healer” at the clinic felt scared and advised her to promptly go for a check-up at the University of Medicine and Pharmacy Hospital, Ho Chi Minh City.

Assoc. Prof. Dr. LêThị Kiều Dung – Specialist advisor of the Obstetrics Department at Ho Chi Minh City Hospital of Dermatology and Venereology said that because the tumor was too large and showed signs of necrosis, severe infection accompanied by full‑thickness peritoneal inflammation, if not treated promptly, the patient is at risk of sepsis, septic shock and may lead to death. Therefore, immediately after admission, the patient received aggressive resuscitation, high‑dose antibiotics to prevent infection, and was then transferred to the operating room to remove the entire uterus. After 2 hours, the surgery was successfully performed. The tumor weighing about 2.6 kg was removed. Histopathology results showed a benign fibroid, and the patient was discharged after 5 days post‑surgery, with stable health condition.

Prof. Dr. Lê Thị Kiều Dung and the team performed surgery for Ms. Q.

The uterine fibroid tumor is very large (2.6 kg), undergoing necrosis, with infection accompanied by severe generalized peritonitis.

Dr. Lê Thị Kiều Dung said that uterine fibroids are a common benign condition in women. About 20 to 30% of women over 30 have this condition. Symptoms vary depending on the size, number and location of the tumor mass. Most tumors are small and cause no symptoms. If the fibroid is not too large and has no complications (compression, abnormal bleeding, pain…) then no specific treatment is needed, only examination

regularly and monitor, by menopause age these tumors will gradually shrink.

In cases where the tumor is large, if detected and treated with the correct method, the patient may still be able to conceive. If the patient does not wish to undergo surgery, the doctor may prescribe medication to prevent the tumor's growth and continue to combine with assisted reproductive techniques to helpThe patient may have a child. In this case, using a needle to directly pierce the patient's uterine fibroid many times to draw blood is a completely unscientific method, never before precedent in medical literature. This is a very dangerous act when the needle tip is repeatedly inserted into a tumor that is not known to be benign or malignant.

In the case of a malignant tumor, it will be extremely dangerous. The needle tip piercesinto, extracting repeatedly will scatter cancer cells, causing the tumor to develop very quickly, spreading throughout the abdominal cavity and leading to distant metastasis. This is a case of benign fibroid but the above unscientific method causes the skin area to be punctured with severe infection, inflammation of the abdominal wall tissue. The tumor punctured many times also gets infected, necrotic and causes peritonitis. To treat definitively, the patient must have the entire uterus removed and lose the chance to become a mother.

Dr. Lê Thị Kiều Dung advises that treatment at private clinics without guaranteed expertise is extremely dangerous. Patients should go to reputable facilities and follow the treatment prescriptions of doctors. For uterine fibroids, intervention is only needed in cases with symptoms of heavy menstrual bleeding, bleeding, or large fibroids invading the uterine cavity, located in a special position causing compression of the bladder or ureter. Usually, patients are treated medically to reduce the tumor volume, after which selective arterial embolization can be performed to shrink the fibroid or a myomectomy can be done. Depending on the number, size of the fibroids and the desire to preserve fertility, doctors will consider myomectomy or hysterectomy.

For patients who have not yet had a child, doctors will coordinate treatment methods to preserve the uterus and maintain the patient’s reproductive function, except in unavoidable cases. Ms. Q. is a very unfortunate case because unscientific treatment at a private clinic forced her to have her entire uterus removed before she could have a child.