Objective: We report a rare case of acute abdomen pain in 27 weeks´ gestation caused by a perforated leiomyoma mimicking pseudomyxoma peritonei on magnetic resonance imaging.

Subject: Case report.

Setting: 1st Department of Gynaecology and Obstetrics. Faculty of Medicine, Comenius University in Bratislava, Slovakia.

Case Report: In our reported case report of perforated leiomyoma mimicking pseudomyxoma peritonei on magnetic resonance imaging. Successful myomectomy was done, and the pregnancy continued with good outcome. At week 40, the patient underwent caesarean section.

Conclusion: Uterine fibroids in pregnancy can lead to severe complications. Their spontaneous rupture in pregnancy is very rare. To manage acute abdominal pain in pregnancy a good diagnostic must be performed, and surgical treatment should be carefully considered.

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