{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T12:25:44Z","timestamp":1781007944271,"version":"3.54.1"},"reference-count":17,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Spontaneous uterine rupture outside of pregnancy is exceptionally rare, with adenomyosis potentially acting as a structurally weakening substrate. Most reports involve gravid patients, underscoring the unusual nature of nongravid presentations. We report the case of a 26-year-old nongravid, nulliparous woman who presented with sudden, diffuse abdominal pain and hemorrhagic shock. Imaging revealed a markedly enlarged, heterogeneous uterus with hemoperitoneum. Emergency laparotomy evacuated approximately 3000\u2009mL of blood. Multiple transmural ruptures precluded repair, necessitating total hysterectomy with adnexal preservation. Histopathology confirmed diffuse adenomyosis with extensive hemorrhagic necrosis.<\/jats:p>\n                  <jats:p>This case highlights that in reproductive-age women presenting with an acute abdomen, a negative pregnancy test, and an enlarged heterogeneous uterus, spontaneous rupture secondary to adenomyosis should be considered. Early resuscitation and definitive surgical management are critical, and proactive counseling is recommended for patients with severe adenomyosis who may be at risk for catastrophic decompensation.<\/jats:p>","DOI":"10.1177\/03000605251399486","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:20:40Z","timestamp":1764289240000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous uterine rupture due to adenomyosis in a nongravid, nulliparous woman: A case report"],"prefix":"10.1177","volume":"53","author":[{"given":"Ling","family":"He","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Ya\u2019an People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4187-4228","authenticated-orcid":false,"given":"Aoxin","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Ya\u2019an People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9560-9979","authenticated-orcid":false,"given":"Yutai","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Ya\u2019an People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Ya\u2019an People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.04.026"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.01.056"},{"key":"e_1_3_9_4_2","article-title":"First trimester spontaneous uterine rupture in a young woman with uterine anomaly","volume":"2014","author":"Tola EN.","year":"2014","unstructured":"Tola EN. First trimester spontaneous uterine rupture in a young woman with uterine anomaly. Case Rep Obstet Gynecol 2014; 2014: 967386.","journal-title":"Case Rep Obstet Gynecol"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14383"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.06.018"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2012.02042.x"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2023-257145"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.12246"},{"key":"e_1_3_9_10_2","first-page":"61","article-title":"Placenta percreta complicated by uterine rupture and thrombotic microangiopathy","volume":"25","author":"Lauzikiene D","year":"2018","unstructured":"Lauzikiene D, Vosylius S, Siaudinyte I, et\u00a0al. Placenta percreta complicated by uterine rupture and thrombotic microangiopathy. 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