Development of Vaginal Pseudoaneurysm 3 Years after Cesarean Section Possibly Induced by Anticoagulant and Antiplatelet Therapies

Abstract

Pseudoaneurysms generally develop when an arterial puncture site is inadequately sealed. We encountered a case of vaginal pseudoaneurysm that developed 3 years after cesarean section in a 35-year-old gravida 7 para 4 woman who was prescribed with anticoagulant and antiplatelet drugs after surgeries for ventricular septal defect and aortic valve replacement. Pelvic computed tomography scan revealed a large mass, which showed a dappled contrast filling on the arterial phase, located in the posterior vaginal wall. The vaginal pseudoaneurysm was completely occluded by embolization of the left vaginal artery. Anticoagulation and antiplatelet therapies can be potential causes of spontaneous pseudoaneurysm rupture. Extrauterine pseudoaneurysm has a long period of time between cesarean section and pseudoaneurysm discovery. Considering that pseudoaneurysm shows different clinical features for each patient, we should always consider pseudoaneurysm when we assess a patient with postpartum hemorrhage.

Recurrent Postpartum Hemorrhage: A Case of Uterine Artery Pseudoaneurysm Probably Induced by Anticoagulants

“…[ 4 ] Anticoagulation therapy has been identified in several reports as a potential factor contributing to the rupture of uterine pseudoaneurysms. [ 5 ] The spontaneous healing of pseudoaneurysms typically occurs through thrombosis. However, any disruption in normal hemostasis can impede this process.…”

Vaginal artery pseudoaneurysm after a hysterectomy: A case report and review of the literature

“… 5 Several reports of postpartum uterine artery or vaginal artery pseudoaneurysms have been published. 5 , 6 , 7 Still, to our best knowledge, no report addressed vaginal artery pseudoaneurysm after hysterectomy. Here, we report a case of vaginal artery pseudoaneurysm following elective hysterectomy in a 51‐year‐old woman.…”

“…However, it can infrequently be caused by pelvic surgeries like hysterectomy 5 . Several reports of postpartum uterine artery or vaginal artery pseudoaneurysms have been published 5–7 . Still, to our best knowledge, no report addressed vaginal artery pseudoaneurysm after hysterectomy.…”