Uterine artery pseudoaneurysm with an anastomotic feeding vessel requiring repeat embolisation
Uterine artery pseudoaneurysm (UAP) is a rare cause of delayed postpartum haemorrhage. Early diagnosis and endovascular management are effective in treating this condition. We present the case of a 36-year-old gravida 3, para 2 woman with delayed postpartum haemorrhage and endometritis following a s...
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| Veröffentlicht in: | BMJ case reports 2018-07, Vol.2018, p.bcr-2018-224656 |
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| creator | Wu, Clara Q Nayeemuddin, Mohammed Rattray, Darrien |
| description | Uterine artery pseudoaneurysm (UAP) is a rare cause of delayed postpartum haemorrhage. Early diagnosis and endovascular management are effective in treating this condition. We present the case of a 36-year-old gravida 3, para 2 woman with delayed postpartum haemorrhage and endometritis following a spontaneous vaginal delivery. Ultrasound and catheter angiogram demonstrated a UAP arising from the distal aspect of the left uterine artery. Significant bleed persisted despite selective bilateral uterine artery embolisation. A repeat angiogram confirmed complete occlusion of bilateral uterine arteries, but abdominal aortogram demonstrated that the left ovarian artery was now feeding the pseudoaneurysm. A repeat embolisation procedure was performed to occlude the left ovarian artery. The patient was discharged the following day. Selective arterial embolisation is effective in the management of UAP. Persistent bleeding despite embolisation should raise the suspicion of anastomotic vascular supply and may require repeat embolisation. |
| doi_str_mv | 10.1136/bcr-2018-224656 |
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Early diagnosis and endovascular management are effective in treating this condition. We present the case of a 36-year-old gravida 3, para 2 woman with delayed postpartum haemorrhage and endometritis following a spontaneous vaginal delivery. Ultrasound and catheter angiogram demonstrated a UAP arising from the distal aspect of the left uterine artery. Significant bleed persisted despite selective bilateral uterine artery embolisation. A repeat angiogram confirmed complete occlusion of bilateral uterine arteries, but abdominal aortogram demonstrated that the left ovarian artery was now feeding the pseudoaneurysm. A repeat embolisation procedure was performed to occlude the left ovarian artery. The patient was discharged the following day. Selective arterial embolisation is effective in the management of UAP. Persistent bleeding despite embolisation should raise the suspicion of anastomotic vascular supply and may require repeat embolisation.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2018-224656</identifier><identifier>PMID: 30002208</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Case reports ; Hemorrhage ; Hysterectomy ; Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation) ; Placenta ; Pregnancy ; Pseudoaneurysm ; Thrombosis ; Ultrasonic imaging ; Veins & arteries</subject><ispartof>BMJ case reports, 2018-07, Vol.2018, p.bcr-2018-224656</ispartof><rights>BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>Copyright: 2018 © BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3716-1a0b3d8579d1013b826860ddbf4612a1a8752cf6f59e889fef5d9c34aeb1175a3</citedby><cites>FETCH-LOGICAL-b3716-1a0b3d8579d1013b826860ddbf4612a1a8752cf6f59e889fef5d9c34aeb1175a3</cites><orcidid>0000-0002-0094-7822</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047716/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047716/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30002208$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Clara Q</creatorcontrib><creatorcontrib>Nayeemuddin, Mohammed</creatorcontrib><creatorcontrib>Rattray, Darrien</creatorcontrib><title>Uterine artery pseudoaneurysm with an anastomotic feeding vessel requiring repeat embolisation</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>Uterine artery pseudoaneurysm (UAP) is a rare cause of delayed postpartum haemorrhage. Early diagnosis and endovascular management are effective in treating this condition. We present the case of a 36-year-old gravida 3, para 2 woman with delayed postpartum haemorrhage and endometritis following a spontaneous vaginal delivery. Ultrasound and catheter angiogram demonstrated a UAP arising from the distal aspect of the left uterine artery. Significant bleed persisted despite selective bilateral uterine artery embolisation. A repeat angiogram confirmed complete occlusion of bilateral uterine arteries, but abdominal aortogram demonstrated that the left ovarian artery was now feeding the pseudoaneurysm. A repeat embolisation procedure was performed to occlude the left ovarian artery. The patient was discharged the following day. Selective arterial embolisation is effective in the management of UAP. Persistent bleeding despite embolisation should raise the suspicion of anastomotic vascular supply and may require repeat embolisation.</description><subject>Abdomen</subject><subject>Case reports</subject><subject>Hemorrhage</subject><subject>Hysterectomy</subject><subject>Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation)</subject><subject>Placenta</subject><subject>Pregnancy</subject><subject>Pseudoaneurysm</subject><subject>Thrombosis</subject><subject>Ultrasonic imaging</subject><subject>Veins & arteries</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc1LwzAYxoMoOubO3qTgRYRqPtokvQgy_ALBi4InQ9K-1Yy22ZJ2sv_ejOlQL4ZA3iS_PLxPHoSOCD4nhPELU_qUYiJTSjOe8x00IiIXqSjwy-6P-gBNQpjhOBjJZMb20QGLG0qxHKHX5x687SDRPharZB5gqJzuYPCr0CYftn9PdBenDr1rXW_LpAaobPeWLCEEaBIPi8H69YGHOeg-gda4xgbdW9cdor1aNwEmX-sYPd9cP03v0ofH2_vp1UNqmCA8JRobVslcFBXBhBlJueS4qkydcUI10VLktKx5nRcgZVFDnVdFyTINhkSfmo3R5UZ3PpgWqhK63utGzb1ttV8pp636fdPZd_XmlorjTMQOosDpl4B3iwFCr1obSmia-BVuCIpigSmThOOInvxBZ27wXbQXKS6FYLxgkbrYUKV3IXiot80QrNbxqRifWsenNvHFF8c_PWz577AicLYBTDv7V-0TnoClJA</recordid><startdate>20180711</startdate><enddate>20180711</enddate><creator>Wu, Clara Q</creator><creator>Nayeemuddin, Mohammed</creator><creator>Rattray, Darrien</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0094-7822</orcidid></search><sort><creationdate>20180711</creationdate><title>Uterine artery pseudoaneurysm with an anastomotic feeding vessel requiring repeat embolisation</title><author>Wu, Clara Q ; Nayeemuddin, Mohammed ; Rattray, Darrien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b3716-1a0b3d8579d1013b826860ddbf4612a1a8752cf6f59e889fef5d9c34aeb1175a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdomen</topic><topic>Case reports</topic><topic>Hemorrhage</topic><topic>Hysterectomy</topic><topic>Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation)</topic><topic>Placenta</topic><topic>Pregnancy</topic><topic>Pseudoaneurysm</topic><topic>Thrombosis</topic><topic>Ultrasonic imaging</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Clara Q</creatorcontrib><creatorcontrib>Nayeemuddin, Mohammed</creatorcontrib><creatorcontrib>Rattray, Darrien</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Clara Q</au><au>Nayeemuddin, Mohammed</au><au>Rattray, Darrien</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Uterine artery pseudoaneurysm with an anastomotic feeding vessel requiring repeat embolisation</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2018-07-11</date><risdate>2018</risdate><volume>2018</volume><spage>bcr-2018-224656</spage><pages>bcr-2018-224656-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>Uterine artery pseudoaneurysm (UAP) is a rare cause of delayed postpartum haemorrhage. Early diagnosis and endovascular management are effective in treating this condition. We present the case of a 36-year-old gravida 3, para 2 woman with delayed postpartum haemorrhage and endometritis following a spontaneous vaginal delivery. Ultrasound and catheter angiogram demonstrated a UAP arising from the distal aspect of the left uterine artery. Significant bleed persisted despite selective bilateral uterine artery embolisation. A repeat angiogram confirmed complete occlusion of bilateral uterine arteries, but abdominal aortogram demonstrated that the left ovarian artery was now feeding the pseudoaneurysm. A repeat embolisation procedure was performed to occlude the left ovarian artery. The patient was discharged the following day. Selective arterial embolisation is effective in the management of UAP. Persistent bleeding despite embolisation should raise the suspicion of anastomotic vascular supply and may require repeat embolisation.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30002208</pmid><doi>10.1136/bcr-2018-224656</doi><orcidid>https://orcid.org/0000-0002-0094-7822</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Abdomen Case reports Hemorrhage Hysterectomy Novel Treatment (New Drug/Intervention Established Drug/Procedure in New Situation) Placenta Pregnancy Pseudoaneurysm Thrombosis Ultrasonic imaging Veins & arteries |
| title | Uterine artery pseudoaneurysm with an anastomotic feeding vessel requiring repeat embolisation |
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