Case Of Uterine Artery Pseudoaneurysm Research Articles

Uterine artery pseudoaneurysm presenting with subcutaneous hematoma and vaginal bleeding following cesarean delivery

We present a rare case of uterine artery pseudoaneurysm (UAP) following an emergency cesarean section, which led to severe vaginal bleeding and subcutaneous hematoma. The patient, a 40-year-old woman with no history of hemophilia or hemostasis disorders, presented with sudden profuse vaginal bleeding and multiple subcutaneous hematomas at the site of the cesarean scar ten days postoperation. Ultrasound and CT scan confirmed the presence of a pseudoaneurysm in the right uterine artery. Due to the unavailability of radiological embolization, surgical ligation of the right internal iliac artery was performed. Postoperative follow-up showed successful resolution of the pseudoaneurysm and cessation of bleeding. This case highlights the importance of considering UAP in the differential diagnosis of postpartum hemorrhage and demonstrates the efficacy of surgical intervention when embolization is not available.

Pseudoaneurysm of the uterine artery post loop electrosurgical excision procedure

BackgroundThe formation of a uterine artery pseudoaneurysm is rare and isolated cases have been reported in the existing literature following caesarean sections, curettages and cone biopsies. There has been no report of pseudoaneurysm formation following a loop electrosurgical excision procedure. Vaginal bleeding could potentially be life threatening if this diagnosis is not considered following cervical instrumentation or surgery. Management options range from haemostatic sutures, image-guided embolisation to surgical repair. We report the diagnosis and management of a case of uterine artery pseudoaneurysm after a loop electrosurgical excision procedure.Case presentationA 37-year-old woman was diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3) and underwent a therapeutic loop electrosurgical excision procedure. One month after the procedure, the patient presented to the emergency department with repeated episodes of sudden-onset heavy vaginal bleeding associated with hypotension and syncope. A computed tomography angiogram was performed, which demonstrated a pseudoaneurysm of the right uterine artery. Following the diagnosis, image-guided embolisation was performed successfully. Post-embolisation angiograms showed successful embolisation of the pseudoaneurysm and the patient had no further episodes of bleeding.ConclusionsLoop electrosurgical excision procedures are generally safe but rarely, can be complicated by the formation of uterine artery pseudoaneurysms. The depth of the loop electrosurgical excision procedure and vascular anatomy should be considered to prevent such complications. A computed tomography angiogram appears to be ideal for diagnosis. Image-guided embolisation is safe and effective as a therapeutic measure, with minimal morbidity.

Three-dimensional computed tomography is effective in diagnosing uterine arterial pseudoaneurysm, a cause of secondary postpartum hemorrhage: A case report

Uterine artery pseudoaneurysm is a rare cause of secondary postpartum hemorrhage. Herein, we report a case of uterine artery pseudoaneurysm, with postpartum hemorrhage commencing 22 days after uncomplicated vaginal delivery. Intermittent bleeding occurred during conservative observation. Transvaginal ultrasound color Doppler imaging revealed swollen vascular structures that suggested arteriovenous malformations, and a saccular dilatation of blood vessels. However, it was insufficient to definitively diagnose the condition as pseudoaneurysm. Meanwhile, the three-dimensional computed tomography angiogram was effective in demonstrating a pseudoaneurysm in the uterus, and an absent early venous return sign, leading to the final diagnosis of a pseudoaneurysm. The patient was successfully treated with transarterial embolization using gelatin sponge pledgets. No bleeding or recurrence of the pseudoaneurysm was observed 2 months after embolization.

EP33.12: A case of uterine artery pseudoaneurysm caused vaginal bleeding during Caesarean section and delayed postpartum hemorrhage

EP33.12: A case of uterine artery pseudoaneurysm caused vaginal bleeding during Caesarean section and delayed postpartum hemorrhage

Endovascular Management of a Rare Cause of Bleeding Per Vaginam: A Hole in the Mole

AbstractUterine artery aneurysm is a rare cause of bleeding per vaginam. Uterine artery pseudoaneurysms are rare but potentially life-threatening causes of persistent or delayed bleeding post-uterine curettage or any uterine surgery. Color Doppler ultrasonography is very useful for emergent diagnosis of these conditions and subsequent follow-up post-embolization. Computed tomography scan and magnetic resonance imaging play an important role in confirming the diagnosis. Transcatheter arterial embolization is the therapy of choice for such cases. Our case highlights the presentation, imaging appearance, and endovascular management of a case of uterine artery pseudoaneurysm.

Uterine artery pseudoaneurysm after cesarean section: case report

Uterine artery pseudoaneurysm (UAP) occurs rarely and can develop after various gynecologic or obstetric procedures. The delayed diagnosis of this disease often results in life-threatening hemorrhage. Here is described a case of UAP after cesarean section. The patient visited gynecology outpatient department of AHD 60 days after cesarean section done outside AHD because of abnormal per vaginal bleeding. After her cesarean section she had undergone laparotomy outside AHD for post partum haemorrhage but those papers were not available. From there she was sent to our radiology department for color Doppler TVS examination and here she was diagnosed as a case of UAP using color Doppler ultrasonography. The most frequent cause of UAP is cesarean section, which accounted for 47.4% of all cases. Previous studies show that the definitive diagnosis was made at angiography (41.2%), computed tomography (29.4%), or color doppler ultrasonography (29.4%). Almost all cases (94.1%) were conservatively treated with transcatheter uterine artery embolization. Consideration of UAP in the differential diagnosis is crucial for proper treatment before rupture and to preserve fertility.Pulse Vol.7 January-December 2014 p.56-60

Uterine Artery Pseudoaneurysm Mimicking Adnexal Mass

Abstract Background: A uterine pseudoaneurysm is an extremely rare arterial wall defect with life-threatening complications such as retroperitoneal hemorrhage. Case: A case of uterine artery pseudoaneurysm in a 38-year-old woman with menorrhagia, and its surgical management, are reported. Results: Exploratory laparotomy was performed. The pseudoaneurysm was identified, ligated, and excised, followed by total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient's postoperative course was uneventful. Conclusions: Despite arterial embolization being an effective and safe treatment, individual circumstances can change the management of uterine pseudoaneurysms. (J GYNECOL SURG 29:336)

Uterine Artery Pseudoaneurysm in the Setting of Delayed Postpartum Hemorrhage: Successful Treatment with Emergency Arterial Embolization

Postpartum hemorrhage is a major cause of maternal mortality. Though uncommon, uterine artery pseudoaneurysm can follow uterine dilatation and curettage (D + C) and needs to be considered in the differential diagnosis. This 30-year-old G1P1 woman presented with right upper quadrant pain and vaginal bleeding. She was afebrile but her white blood count was significantly increased (22.2 × 109 /L). One week prior, she had undergone a Cesarean delivery which was complicated by hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP), fetal dystocia, and chorioamnionitis. Uterine dilatation and curettage (D & C) and placement of a Bakri intrauterine balloon, performed for suspected retained products of conception, failed to control her postpartum bleeding. The patient wished to have a hysterectomy only as a last resort in order to preserve fertility. Emergency uterine artery angiography revealed a left uterine artery pseudoaneurysm and contrast extravasation. The patient was successfully treated with selective embolization. Computed tomography (CT) later revealed dehiscence of her uterine Cesarean section incision with an intra-abdominal fluid collection. This collection was drained. She also developed disseminated intravascular coagulopathy (DIC) syndrome as well as multiple pulmonary emboli which were both successfully treated. We discuss this unique case of uterine artery pseudoaneurysm with associated uterine dehiscence.

Uterine artery pseudoaneurysm: Unusual cause of delayed postpartum hemorrhage

We describe a case of uterine artery pseudoaneurysm in a 21-year-old woman with postpartum hemorrhage. This condition is easily diagnosed with duplex Doppler sonography and can be treated with embolization, but only if delayed postpartum hemorrhage is considered in the differential diagnosis.

Pseudoaneurysm of the Uterine Artery Requiring Bilateral Uterine Artery Embolization

To report a case of uterine artery pseudoaneurysm which initially failed unilateral uterine artery embolization that subsequently responded to bilateral embolization. A case report. University hospital. 32-year-old G(2) P(1) female. Left uterine artery embolization followed by right uterine artery embolization 1 day later. Vaginal bleeding, hemoglobin. Unilateral uterine artery embolization failed to control vaginal bleeding. Repeat embolization of the contralateral side was successful. Uterine artery embolization is an effective method of treating delayed postpartum hemorrhage secondary to a pseudoaneurysm of the uterine artery.

PSEUDOANEURYSM OF THE UTERINE ARTERY

In Brief Background Preexisting aneurysms in several arterial locations have been associated with an increased risk of rupture in pregnancy. We report a rare case of uterine artery pseudoaneurysm that presented during the puerperium. Case A 31-year-old woman had moderate suprapubic pain on postpartum day 8. The diagnosis of uterine artery aneurysm was made by duplex Doppler sonography and confirmed by arteriography. It was successfully treated by embolization of the left uterine artery. Conclusion In a rare case of pseudoaneurysm of the uterine artery, the complications of pregnancy-related aneurysmal rupture were prevented by prompt sonographic diagnosis and embolization therapy. Sonographic diagnosis and embolization therapy of a uterine artery pseudoaneurysm prevented complications of pregnancy-related rupture.

Pseudoaneurysm of the uterine artery

Background: Preexisting aneurysms in several arterial locations have been associated with an increased risk of rupture in pregnancy. We report a rare case of uterine artery pseudoaneurysm that presented during the puerperium. Case: A 31-year-old woman had moderate suprapubic pain on postpartum day 8. The diagnosis of uterine artery aneurysm was made by duplex Doppler sonography and confirmed by arteriography. It was successfully treated by embolization of the left uterine artery. Conclusion: In a rare case of pseudoaneurysm of the uterine artery, the complications of pregnancy-related aneurysmal rupture were prevented by prompt sonographic diagnosis and embolization therapy.