Non-Obstetrics vulvar hematomas, though rare, can present as significant gynaecological emergencies following trauma. We report a case of an 18-year-old female who sustained a vulvar hematoma after performing a split during a night out and landing directly on her vulva. She presented to the Accident & Emergency (A&E) department with severe pain, significant tenderness, and gross bruising and referred to gynaecology team. On examination, the hematoma was measured at 12x5 cm, with swelling extending into the vagina. The patient was unable to pass urine and could not tolerate a full examination due to the intensity of the pain. Given the severity of the injury, she was urgently taken to theatre for an examination under anaesthesia (EUA) and I&D (Incision and drainage of haematoma).

Approximately 100 ml of blood clots were evacuated, and several active bleeding points were identified and sutured using 3-0 Vicryl Rapide to control the haemorrhage.

The patient required a seven-day hospitalization due to significant pain and difficulty mobilizing. Despite the severity of the injury, including extensive swelling, the patient made a full recovery and was discharged on the seventh day without further complications. This case highlights the importance of prompt intervention and a multidisciplinary approach to managing vulvar hematomas as gynaecological emergencies.

Dr. Aye Thiri Kyaw completed her MBBS at the University of Medicine 1 Yangon in 2012 and earned an MSc in Clinical Science (Reproductive and Maternal Medicine) from the University of Glasgow in 2015. She completed her MRCOG in 2024. Dr. Kyaw’s areas of special interest are subfertility and menopause care. She is currently an ST6 Obstetrics and Gynecology specialty trainee in the Northwest Deanery, working at Whiston Hospital. She manages a wide range of obstetric and gynecological emergencies, providing care to improve patient outcomes and deliver comprehensive support for women’s health.