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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2019; 03(02): 122-125
DOI: 10.1055/s-0039-1685238
Case Report
Indian Society of Vascular and Interventional Radiology

Endovascular Management of a Rare Cause of Bleeding Per Vaginam: A Hole in the Mole

Anurag Chahal
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
,
Sundeep Malla
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
,
Shivanand Gamanagatti
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
› Author Affiliations
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Publication History

Received: 19 November 2018

Accepted after revision: 28 January 2019

Publication Date:
18 April 2019 (online)

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Abstract

Uterine artery aneurysm is a rare cause of bleeding per vaginam. Uterine artery pseudoaneurysms are rare but potentially life-threatening causes of persistent or delayed bleeding post-uterine curettage or any uterine surgery. Color Doppler ultrasonography is very useful for emergent diagnosis of these conditions and subsequent follow-up post-embolization. Computed tomography scan and magnetic resonance imaging play an important role in confirming the diagnosis. Transcatheter arterial embolization is the therapy of choice for such cases. Our case highlights the presentation, imaging appearance, and endovascular management of a case of uterine artery pseudoaneurysm.

Keywords

uterine artery - pseudoaneurysm - embolization
 

  • References

  • 1 Biscaro A, Braga A, Berkowitz RS. Diagnosis, classification and treatment of gestational trophoblastic neoplasia. Rev Bras Ginecol Obstet 2015; 37 (01) 42-51
    PubMedGoogle Scholar
  • 2 Zimon AE, Hwang JK, Principe DL, Bahado-Singh RO. Pseudoaneurysm of the uterine artery. Obstet Gynecol 1999; 94 (05) Pt 2 827-830
    PubMedGoogle Scholar
  • 3 Karmous N, Ayachi A, Derouich S, Mkaouar L, Mourali M. Rupture of uterine artery pseudoaneurysm: role of ultrasonography in postpartum hemorrhage management. Pan Afr Med J 2016; 25: 136
    PubMedGoogle Scholar
  • 4 Langer JE, Cope C. Ultrasonographic diagnosis of uterine artery pseudoaneurysm after hysterectomy. J Ultrasound Med 1999; 18 (10) 711-714
    CrossrefPubMedGoogle Scholar
  • 5 Keepanasseril A, Suri V, Prasad GRV. et al. Management of massive hemorrhage in patients with gestational trophoblastic neoplasia by angiographic embolization: a safer alternative. J Reprod Med 2011; 56 (05) (06) 235-240
    PubMedGoogle Scholar
  • 6 Kim GM, Yoon CJ, Seong NJ, Kang SG, Kim YJ. Postpartum haemorrhage from ruptured pseudoaneurysm: efficacy of transcatheter arterial embolisation using N-butyl-2-cyanoacrylate. Eur Radiol 2013; 23 (08) 2344-2349
    CrossrefPubMedGoogle Scholar
  • 7 Ros C, Barnes D, Fervienza A. et al. Ultrasound-guided transvaginal thrombin injection of uterine arteries pseudoaneurysms. Br J Radiol 2017; 90 1074 20160913
    CrossrefPubMedGoogle Scholar