Abstract
BackgroundUterine artery embolization in the treatment of uterine leiomyoma has been rarely associated with dislodgement and expulsion of infarcted uterine fibroids through the vagina, peritoneum, or bowel wall, predominantly occurring within 6 months of uterine artery embolization.Case presentationWe present the case of a 54-year-old African American woman who underwent uterine artery embolization 11 years prior and developed mechanical small bowel obstruction from the migration of fibroid through a uteroenteric fistula with ultimate impaction within the distal small bowel lumen. Small bowel resection and hysterectomy were curative.ConclusionsUteroenteric fistula with small bowel obstruction due to fibroid expulsion may present as a delayed finding after uterine artery embolization and requires heightened awareness.
Highlights
Uterine artery embolization in the treatment of uterine leiomyoma has been rarely associated with dislodgement and expulsion of infarcted uterine fibroids through the vagina, peritoneum, or bowel wall, predomi‐ nantly occurring within 6 months of uterine artery embolization.Case presentation: We present the case of a 54-year-old African American woman who underwent uterine artery embolization 11 years prior and developed mechanical small bowel obstruction from the migration of fibroid through a uteroenteric fistula with ultimate impaction within the distal small bowel lumen
Case presentation A 54-year-old gravida 1 para 1 African American woman with a history of hypertension, uncomplicated diverticulitis, and multiple uterine fibroids status post Uterine artery embolization (UAE) presented to the emergency department (ED) with 3 days of severe, colicky abdominal pain, inability to tolerate oral intake, and bilious emesis
Ten years following UAE, her intermenstrual bleeding recurred, and Magnetic resonance imaging (MRI) suggested the presence of one viable subserosal leiomyoma
Summary
Uteroenteric fistula with small bowel obstruction due to fibroid expulsion may present as a delayed finding after uterine artery embolization and requires heightened awareness.
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