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Hemorrhage after myomectomy resulting from pseudoaneurysm of the uterine artery.

Higón MA, Domingo S, Bauset C, Martínez J, Pellicer A

Department of Obstetrics and Gynecology, Hospital Universitario Dr Peset, Valencia, Spain.

OBJECTIVE: To study a case of uterine artery hemorrhage after laparotomic myomectomy in a 40-year-old woman. DESIGN: Retrospective clinical case. SETTING: Tertiary clinical care university hospital. PATIENT(S): A 40-year-old woman, 1 month after a laparotomic myomectomy presenting sudden metrorrhagia. INTERVENTION(S): The diagnosis of uterine artery pseudoaneurysm was made by color and duplex Doppler ultrasonography (CDDUS) and confirmed by arteriography. The angiographic study showed an intramyometrial uterine artery pseudoaneurysm. MAIN OUTCOME MEASURE(S): Clinical response to treatment. RESULT(S): The uterine artery pseudoaneurysm was successfully treated by embolization. The patient's recovery was extraordinary, and now she has normal menses. CONCLUSION(S): CDDUS is a useful imaging technique in the diagnosis of arterial pseodoaneurysms. Transcatheter arterial embolization is a good alternative for management. It has the advantage that it is a less invasive technique and also is able to preserve the reproductive function.

Published 5 February 2007 in Fertil Steril, 87(2): 417.e5-8.
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