Puerperal vulvovaginal hematoma with an uncommon feeding vessel from the inferior mesenteric artery: a case report

Abstract

Puerperal hematoma is a serious obstetric complication. We report a case of a large puerperal hematoma with an uncommon feeding vessel originating from an inferior mesenteric artery. A 28-year-old primiparous woman was transferred to our hospital with a large hematoma in the left vaginal wall following normal vaginal delivery. Contrast-enhanced CT revealed an actively bleeding vulvovaginal hematoma 9 cm in diameter, and transcatheter arterial embolization was performed. Arteriogram of the internal iliac arteries did not reveal a feeding vessel. Embolization of the peripheral branch of the superior rectal artery, which originated from the inferior mesenteric artery, achieved hemostasis. If the internal iliac arteries are not the source of active bleeding, more proximal angiography of the inferior mesenteric artery is recommended to assess uncommon feeding vessels.