Abstract
Background: Uterine artery pseudoaneurysm is a rare diagnosis made postoperatively after pelvic surgery. The exact etiology is unknown however it is speculated to occur when an artery is lacerated and the perivascular tissue maintains persistent blood flow with the parent vessel. It can present with severe hemorrhage two to four weeks after an uncomplicated post operative course. Case: A 45 year old presented with vaginal hemorrhage and hypotension two weeks after abdominal myomectomy. Transvaginal ultrasound with doppler diagnosed pseudoaneurysm of the uterine artery. The patient was successfully treated with endovascular embolization utilizing micro coils. Conclusion: Transvaginal ultrasound is a useful technique in diagnosing pseudoaneurysms. Endovascular embolization is a minimally invasive, safe and effective way to treat this rare complication in institutions that have access to interventional radiology procedures.
Highlights
Pseudoaneurysm is a tear through all the layers of an artery with persistent flow outside the vessel into a space contained by the surrounding perivascular tissue [1]
The exact etiology is unknown it is speculated to occur when an artery is lacerated and the perivascular tissue maintains persistent blood flow with the parent vessel. It can present with severe hemorrhage two to four weeks after an uncomplicated post operative course
Case reports have documented successful treatment with uterine artery embolization [3,4]. In this case report we present a uterine artery pseudoaneurysm diagnosed two weeks after an uncomplicated abdominal myomectomy
Summary
Pseudoaneurysm is a tear through all the layers of an artery with persistent flow outside the vessel into a space contained by the surrounding perivascular tissue [1]. There are case reports of bleeds only two to three days following laparoscopic myomectomies [2]. This phenomenon has been diagnosed via color Doppler ultrasound, CT angiography and MRI, with ultrasound being the most common diagnostic modality [3]. Case reports have documented successful treatment with uterine artery embolization [3,4]. In this case report we present a uterine artery pseudoaneurysm diagnosed two weeks after an uncomplicated abdominal myomectomy. Higone et al, 2007 reported the only other case following abdominal myomectomy [4]
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