External iliac artery thrombosis after hypogastric artery ligation and pelvic packing for placenta previa percreta/Plasenta previa perkreata yonetimi icin hipogastrik arter ligasyonu ve pelvik kompres sonrasi eksternal iliak arter trombozu

Placenta previa percreta is a serious pregnancy condition that may cause massive bleeding. Life-threatening hemorrhage is commonly managed via cesarean hysterectomy or vascular ligations in order to preserve fertility. We present a case of bilateral external iliac artery thrombosis after pelvic compression and uterine devascularization due to placenta previa percreta. The patient had cesarean section due to ultrasonography and magnetic resonance imaging-diagnosed placenta previa percreta, and stated that she preferred a conservative approach rather than hysterectomy in a case of massive bleeding. Spontaneous hemorrhage was recognized during the operation. Pelvic compression and bilateral uterine and internal iliac artery ligations were performed. The left external iliac artery was accidentally held and bonded as the left internal iliac artery, which was turned loose within a minute after distinguishing the vessels. Emergency angiography that was applied because of patient's leg pain showed bilateral external iliac artery thrombosis. Angioplasty was performed by a cardiologist for bilateral occlusions. Placenta invasion abnormalities may be managed by pelvic compression or vascular ligations, which have their own serious complications that the surgeon must manage immediately. Keywords: Arterial ligation, pelvic packing, thrombosis, placenta previa, placenta percreta Plasenta previa perkreata asiri kanama ile sonuclanabilen ciddi bir gebelik durumudur. Yasami tehdit eden kanamalar genellikle sezaryen histerektomi veya fertilite korumaya yonelik bir yontem olarak damar ligasyonlari ile kontrol edilir. Plasenta previa perkreata sebebiyle uterus devaskularizasyonu ve pelvik kompresi takiben gelisen bilateral eksternal iliak arter trombozu olgusu sunulmaktadir. Hasta ultrason ve manyetik rezonans goruntuleme ile tanisi konan plasenta previa perkreata nedeniyle sezaryen operasyonuna alindi, ameliyat oncesinde masif kanama durumunda uterus koruyucu cerrahi tercih ettigini belirtti. Operasyon sirasinda spontan kanama fark edildi. Bilateral uterin ve hipogastrik arterlerin baglanmasi ardindan pelvik kompres uygulandi. Sol eksternal iliak arter sol hipogastrik arter ile karistirilarak baglandi, bir dakika icerisinde fark edilerek sutur acildi. Post operatif donemde hastanin bacak agrisi tarif etmesi uzerine acil anjiyograf cekildiginde bilateral eksternal iliak arter trombozu fark edildi. Bilateral tikanikliklar icin kardiyoloji uzmani tarafindan anjiyoplasti uygulan