Uterine artery pseudoaneurysm

Case contributed by Dr Aliakbar Sahraei

Presentation

G3P3 underwent caesarian section (CS) at 40 weeks' gestation due to previous CS. Admitted to the emergency department due to abnormal uterine bleeding (manifesting as menstrual bleeding) 10 days after CS.

Patient Data

Age: 30 years
Gender: Female
Ultrasound

Transvaginal

Longitudinal gray-scale US image shows a cystic lesion in the uterus. Colour Doppler US image shows that the sac is filled with blood. Longitudinal duplex Doppler US image shows the to-and-fro pattern flow within the pseudoaneurysm. 

DSA (angiography)

Uterine artery

Right internal iliac angiogram shows the pseudoaneurysm, which is supplied by the right uterine artery.

Case Discussion

Uterine artery pseudoaneurysm (UAP) is a rare cause of secondary postpartum haemorrhage.

 In this case, transvaginal colour Doppler US showed a 12 mm cystic structure in right wall of uterus with varying colours and yin-yang appearance. Duplex Doppler US showed turbulent flow within the structure, Doppler US scan identified to-and-fro flow in the sac, indicating a pseudoaneurysm.

Bilateral angiogram confirmed pseudoaneurysm in the right uterine artery.

Angiography and embolization performed by Dr Mohammad Momen Gharibvand, interventional radiologist at Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.

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Case information

rID: 53961
Case created: 15th Jun 2017
Last edited: 27th Jun 2017
Inclusion in quiz mode: Included

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