EURORAD ESR

Case 13699

Uterine artery pseudoaneurysm: A rare life-threatening cause of secondary post partum haemorrhage

Author(s)
Minu Mohandas1, Sreeraj Nadarajan2, Sara Ammu Chacko1, Nita H1, Manish Kumar Yadav2.

1Dr.SMCSI Medical college, Karakonam
2Kerala Institute of Medical Sciences, Thiruvananthapuram
Department of Radiology,
Kerala Institute of Medical Sciences,
Anayara P O 695029
Thiruvananthapuram;
Email:sreeraj70@msn.com
 
Patient
female, 26 year(s)
 
 
  • Figure 1
    Ultrasonography
     

    Sagittal sonogram of uterus (B&W) showing well-defined rounded cystic lesion with colour filling in anterior myometrium.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Embolisation; Special Focus: Aneurysms;

    Spectral Doppler showing marked turbulence in the lesion.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Embolisation; Special Focus: Aneurysms;
     
     
  • Figure 2
    CT angiography
     

    CT axial section showing a well-circumscribed globular contrast filled lesion in left anterior myometrium of uterus suggestive of pseudoaneurysm.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT-Angiography; Procedure: Embolisation; Special Focus: Aneurysms;

    CT coronal section showing the pseudoaneurysm in left anterior myometrium of uterus.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT-Angiography; Procedure: Embolisation; Special Focus: Aneurysms;
     
     
  • Figure 3
    DSA
     

    Left internal iliac arteriogram showing a contrast-filled smooth outpouching suggestive of pseudoaneurysm.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Catheter arteriography; Procedure: Embolisation; Special Focus: Aneurysms;

    Selective injection of left uterine artery using a microcatheter showing the pseudoaneurysm in its terminal part.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Catheter arteriography; Procedure: Embolisation; Special Focus: Aneurysms;
     
     
  • Figure 4
    DSA embolisation
     

    Embolisation of pseudoaneurysm using N-butyl cyanoacrylate.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Catheter arteriography; Procedure: Embolisation; Special Focus: Aneurysms;

    Post-embolisation left internal iliac arteriogram. Now the psedoaneurysm is not filling.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Catheter arteriography; Procedure: Embolisation; Special Focus: Aneurysms;
     
     
Sagittal sonogram of uterus (B&W) showing well-defined rounded cystic lesion with colour filling in anterior myometrium.
 
Spectral Doppler showing marked turbulence in the lesion.
 
CT axial section showing a well-circumscribed globular contrast filled lesion in left anterior myometrium of uterus suggestive of pseudoaneurysm.
 
CT coronal section showing the pseudoaneurysm in left anterior myometrium of uterus.
 
Left internal iliac arteriogram showing a contrast-filled smooth outpouching suggestive of pseudoaneurysm.
 
Selective injection of left uterine artery using a microcatheter showing the pseudoaneurysm in its terminal part.
 
Embolisation of pseudoaneurysm using N-butyl cyanoacrylate.
 
Post-embolisation left internal iliac arteriogram. Now the psedoaneurysm is not filling.
 
 
 
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