首页>
美国卫生研究院文献>BMJ Case Reports
>Unusual presentation of more common disease/injury: Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm successfully treated by transarterial embolisation
【2h】
Unusual presentation of more common disease/injury: Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm successfully treated by transarterial embolisation
A 29-year-old woman (gravida 1, para 1) had an uneventful first pregnancy and a delivery by emergency caesarean section at term. The caesarean section was complicated by a massive obstetric haemorrhage of 5000 ml. After closure, an immediate re-laparotomy was indicated due to heavy vaginal bleeding. The site of bleeding was identified as an extension of the uterine incision, and was sutured. She was stabilised by transfusion of blood and blood products in the intensive therapy unit, and discharged 5 days later. The patient was re-admitted 6 weeks later with brisk, painless vaginal bleeding, passing large clots from a well-contracted uterus. Her haemoglobin decreased from 11.8 to 7.8 g/dl overnight. In view of her history, an urgent CT angiogram was performed, which revealed the presence of a pseudo-aneurysm arising from the left uterine artery. This was successfully occluded by transarterial embolisation, obviating the need for further surgical exploration.
展开▼
机译:一名29岁的妇女(妊娠1,第1段)初次怀孕很顺利,足月经剖腹产紧急分娩。剖宫产因5000毫升的大量产科出血而复杂化。闭合后,由于大量阴道出血,应立即进行再次开腹手术。出血部位被确定为子宫切口的延伸,并被缝合。通过在强化治疗室输血和输血使她稳定下来,并在5天后出院。 6周后,该患者再次入院,出现轻快,无痛的阴道出血,并从收缩良好的子宫中传出了大块血块。过夜的血红蛋白从11.8降至7.8 g / dl。考虑到她的病史,进行了紧急的CT血管造影,发现存在来自左子宫动脉的假性动脉瘤。经动脉栓塞成功地消除了这种情况,从而无需进行进一步的手术探查。
展开▼