Pseudoaneurysm after abdominal myomectomy: A rare but catastrophic complication

May-Tal Sauerbrun-Cutler, Jason Kanos, Adie Friedman, Sarah Bernstein

Department of Interventional Radiology, St. Luke’s Roosevelt Hospital Center, New York, USA.
Department of Obstetrics and Gynecology, St. Luke’s Roosevelt Hospital Center, New York, USA.
Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.

DOI: 10.4236/ojog.2013.31023                

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.

Keywords

Myomectomy; Pseudoaneurysm; Ultrasound

Conflicts of Interest

The authors declare no conflicts of interest.

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