Uterine Artery Pseudoaneurysm: A Life-Threatening Cause of Vaginal Bleeding in the Emergency Department

2019 ◽  
Vol 56 (3) ◽  
pp. 327-331 ◽  
Author(s):  
Lindsey Jennings ◽  
Brad Presley ◽  
Diann Krywko
Keyword(s):  
Emergency Department ◽  
Vaginal Bleeding ◽  
Uterine Artery ◽  
Artery Pseudoaneurysm ◽  
Life Threatening ◽  
Uterine Artery Pseudoaneurysm

scholarly journals Massive Secondary Postpartum Hemorrhage with Uterine Artery Pseudoaneurysm after Cesarean Section

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ahmet Ozgur Yeniel ◽  
Ahmet Mete Ergenoglu ◽  
Ali Akdemir ◽  
Elmin Eminov ◽  
Fuat Akercan ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Uterine Artery ◽  
Angiographic Embolization ◽  
Artery Ligation ◽  
Artery Pseudoaneurysm ◽  
Uterine Artery Ligation ◽  
Life Threatening ◽  
Secondary Postpartum Hemorrhage ◽  
Uterine Artery Pseudoaneurysm

Uterine artery pseudoaneurysm is a rare but serious complication of cesarean section. If inadequately treated, it can lead to life-threatening postpartum hemorrhage. Herein, we report the case of a 28-year-old woman who developed secondary postpartum hemorrhage resulting from uterine artery pseudoaneurysm and cesarean scar dehiscence after cesarean section. Angiographic embolization is a safe and effective procedure for treating postpartum hemorrhage resulting from pseudoaneurysm in hemodynamically stable patients. However, uterine artery ligation may be the surgical procedure of choice for hemodynamically unstable patients when fertility preservation is desired.

scholarly journals Pseudoaneurysm of the uterine artery post loop electrosurgical excision procedure

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Judith Ong ◽  
Kelvin Lee ◽  
Soe-Na Choo ◽  
Stanley Loh ◽  
Li Min Lim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Vaginal Bleeding ◽  
Uterine Artery ◽  
Management Options ◽  
Artery Pseudoaneurysm ◽  
Image Guided ◽  
Computed Tomography Angiogram ◽  
Uterine Artery Pseudoaneurysm ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure

Abstract Background The 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 presentation A 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. Conclusions Loop 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.

scholarly journals Uterine artery pseudoaneurysm after treatment of cesarean scar pregnancy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiao Wang ◽  
Qing Yang ◽  
Ningning Zhang ◽  
Dandan Wang
Keyword(s):  
Vaginal Bleeding ◽  
Uterine Artery ◽  
Rare Complication ◽  
Transvaginal Ultrasound ◽  
Massive Hemorrhage ◽  
Cesarean Scar Pregnancy ◽  
Artery Pseudoaneurysm ◽  
Cesarean Scar ◽  
Effective Diagnosis ◽  
Uterine Artery Pseudoaneurysm

Abstract Background Pseudoaneurysms are formed when a local arterial wall ruptures, leading to hemorrhage and hematoma adjacent to the artery. Continuous perfusion of the injured artery increases the pressure in the lumen of the pseudoaneurysm. It may rupture and lead to massive hemorrhage that could be life-threatening. Cesarean scar pregnancy (CSP) is an ectopic pregnancy where the gestational sac is implanted in the cesarean scar. Uterine artery pseudoaneurysm (UAP) after CSP treatment is rare. Case presentation We report the case of a 36-year-old Chinese woman who presented with acute massive vaginal bleeding 53 days after transabdominal scar pregnancy excision. Doppler ultrasound confirmed UAP. Selective uterine artery embolization (UAE) failed because of the thin and curved blood vessels. The lesion decreased in size after transvaginal ultrasound-guided direct thrombin injection (UGTI); however, massive vaginal bleeding recurred and endangered the patient’s life. The uterus was removed thereafter. Conclusions UAP is a rare complication after CSP treatment that can lead to fatal massive hemorrhage. Ultrasound should be reexamined regularly after treatment of CSP. In case of unexplained vaginal bleeding, we should be alert to the existence of UAP and the possibility of rupture and take effective diagnosis and treatment measures promptly.

Bilateral uterine artery embolization for the management of bilateral uterine artery pseudoaneurysm during puerperium: A case report

2021 ◽  
Vol 10 (1) ◽  
pp. 22-23
Author(s):  
Sally Damra Elnour Mohammed ◽  
Mohammed Khidir Tayfor ◽  
Isra Mutasim Hamad ◽  
Mashaar Osama
Keyword(s):  
Ct Angiography ◽  
Uterine Artery ◽  
Delayed Diagnosis ◽  
Arterial Embolization ◽  
Bleeding Events ◽  
Selective Embolization ◽  
Artery Pseudoaneurysm ◽  
Life Threatening ◽  
The Right ◽  
Uterine Artery Pseudoaneurysm

Background: Uterine artery Pseudoaneurysm is a rare cause of secondary postpartum hemorrhage (PPH) and can develop after various gynecological or obstetric procedures. The delayed diagnosis of such cases often results in life threatening situations. We report a rare case of bilateral uterine artery pseudoaneurysm that led to life threatening secondary PPH after Caesarean section in a patient who had several Caesarean sections before. Case description: A 35 years old multiparus women, who had all her four deliveries by Caesarean sections, presented with recurrent massive attacks of secondary PPH 35ays after her last delivery. Rupture of aneurysm of the uterine artery was suspected and CT angiography showed that the left uterine artery seemed more dilated and was probably the source of the PPH. The bleeding site was successfully tackled by selective arterial embolization. About three weeks later the patient presented again with severe recurrence of PPH. Repeat of CT angiography showed that the source was the right uterine artery this time, which was again selectively embolized. No further bleeding events occurred up to two years follow-up. Conclusion: Rupture of aneurysm of the uterine artery can be a life-threatening condition. Clinical suspicion is essential for a prompt diagnosis Definitive diagnosis can be achieved by CT-angiography. Treatment by selective embolization can effectively stop the bleeding.

scholarly journals Postpartum Pseudoaneurysm After Cesarean Delivery

2018 ◽  
Vol 35 (2) ◽  
pp. 136-140 ◽  
Author(s):  
Dora DiGiacinto ◽  
Jennifer E. Bagley ◽  
Bradford Gildon ◽  
Gina Cantrell
Keyword(s):  
Cesarean Delivery ◽  
Uterine Artery ◽  
Liver Enzymes ◽  
Vascular Lesion ◽  
Artery Pseudoaneurysm ◽  
Elevated Liver Enzymes ◽  
Life Threatening ◽  
History Of ◽  
Low Platelet Count ◽  
Uterine Artery Pseudoaneurysm

Uterine artery pseudoaneurysm is an uncommon vascular lesion that can be life threatening. A ruptured uterine artery pseudoaneurysm can cause acute massive hemorrhaging, creating a true emergency for the postpartum patient. The etiology is more commonly seen with traumatic procedures such as cesarean delivery or curettage. This case report is of a patient with a history of HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome who presented with heavy bleeding after a cesarean delivery. Sonography was primarily used to diagnose the uterine artery pseudoaneurysm. Because of the massive hemorrhaging in this case, a hysterectomy was performed.

Uterine Artery Pseudoaneurysm: A Case Report

2020 ◽  
Vol 36 (3) ◽  
pp. 273-276
Author(s):  
Mahmoud S. Babiker
Keyword(s):  
Uterine Artery Embolization ◽  
Vaginal Bleeding ◽  
Rare Case ◽  
Uterine Artery ◽  
Arterial Wall ◽  
Caesarian Section ◽  
Artery Embolization ◽  
Artery Pseudoaneurysm ◽  
Arterial Blood ◽  
Uterine Artery Pseudoaneurysm

Pseudoaneurysm is an extraluminal collection of blood with a turbulent flow that communicates with flowing arterial blood through a defect in the arterial wall. Uterine artery pseudoaneurysm (UAP) is considered a rare case that occurs in 2–3/1,000 deliveries. A 33-year-old pregnant woman was admitted for a planned caesarian section. After a successful delivery, the patient experienced a postpartum vaginal bleeding 3 days later. Sonography revealed a suspected right UAP, and the diagnosis was confirmed by angiography. The defect was treated by uterine artery embolization.

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