Small bowel obstruction associated with a leiomyomatous uterus. A case report and review of the literature. A 38-year-old woman developed small bowel obstruction shortly after a cholecystectomy because of a massively enlarged leiomyomatous uterus. Small bowel obstruction is a relatively rare complication from fibroid tumors and results from entrapment of the bowel between serosal pedunculated fibroids (as in this patient), adhesions to infarcted leiomyomas, or from compression of the small bowel by the large mass. Large uterine leiomyomas clearly must be considered in the etiology of intestinal obstruction. 