Kakinuma K, Kakinuma T, Ueyama K, Okamoto R, Yanagida K, Takeshima N, Ohwada M. Uterine artery pseudoaneurysm caused by hysteroscopic surgery: A case report. World J Clin Cases 2024; 12(26): 5968-5973 [PMID: 39286372 DOI: 10.12998/wjcc.v12.i26.5968]
Corresponding Author of This Article
Toshiyuki Kakinuma, MD, PhD, Doctor, Professor, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan. tokakinuma@gmail.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kaoru Kakinuma, Toshiyuki Kakinuma, Kyouhei Ueyama, Rora Okamoto, Kaoru Yanagida, Nobuhiro Takeshima, Michitaka Ohwada, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
Author contributions: Kakinuma K and Kakinuma T contributed to conceptualization, methodology, software, validation, original draft preparation, manuscript review and editing, visualization, supervision, and project administration; Ueyama K, Okamoto R, Yanagida K, Takeshima N, Ohwada M contributed to the formal analysis, investigation, resources, and data curation; All authors have read and agreed to the published version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiyuki Kakinuma, MD, PhD, Doctor, Professor, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan. tokakinuma@gmail.com
Received: March 26, 2024 Revised: June 19, 2024 Accepted: July 5, 2024 Published online: September 16, 2024 Processing time: 118 Days and 22.2 Hours
Abstract
BACKGROUND
We report a case of uterine artery pseudoaneurysm (UAP) occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization (UAE).
CASE SUMMARY
A 48-year-old primigravid, primiparous patient was incidentally found to have an endometrial polyp during a health checkup, and underwent a hysteroscopic polypectomy at another hospital. Her cervix was dilated with a Laminken-R® device. After the Laminken-R® was withdrawn, a large amount of genital bleeding was observed. This bleeding persisted after the hysteroscopic polypectomy, and, as hemostasis became impossible, the patient was transferred to our hospital by ambulance. On arrival, transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus, and color Doppler ultrasonography showed feeder vessels penetrating the mass. Pelvic contrast-enhanced computed tomography (CT) confirmed the presence of a mass at this site, and vascular proliferation was observed within the uterine cavity. Consequently, UAP was diagnosed, and UAE was performed. The patient’s postoperative course was uneventful, and 6 mo post-UAE, no recurrence of blood flow to the UAP was observed.
CONCLUSION
When abnormal genital bleeding occurs during hysteroscopic surgery, ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs.
Core Tip: When abnormal uterine bleeding occurs after hysteroscopic surgery, the possibility of uterine artery pseudoaneurysm (UAP) must be considered. Confirmed UAP must be managed promptly and appropriately.
