Pseudoaneurysm after abdominal myomectomy: A rare but catastrophic complication

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.

Pseudoaneurysm of uterine artery complicating caesarean section: a rare cause of intractable secondary postpartum haemorrhage managed with uterine artery embolisation

“…The colour Doppler flow demonstrates a classic to and fro pattern, with flow velocity being high immediately following systole and then slow or reversed following diastole. Colour Doppler flow sonography improves the specificity of diagnosis to 95% and sensitivity to 94% 9. Definitive diagnosis can be made with the help of angiography, CT and magnetic resonance sonography 10…”

Spontaneous Uterine Artery Pseudoaneurysm Rupture Following Cesarean Section: A Case Report

“…Cesarean section is the most common cause but this complication has also been reported in association with abortion, repeated curettage, myomectomy, hysterectomy and even uncomplicated vaginal delivery [4].…”

“…Hysterectomy is the last choice if uterine artery ligation by surgery or embolization is not effective to control bleeding [4]. The first case of selective arterial embolization that used successfully to treat uncontrollable postpartum bleeding was reported by Brown et al in 1979 [10].…”