Uterine Necrosis after Uterine Artery Embolization for Symptomatic Fibroids

Case Reports in Obstetrics and Gynecology
Steve Kyende MutisoTimona Obura

Abstract

Uterine artery embolization (UAE) is a minimally invasive intervention that is used in the treatment of fibroids. UAE can lead to complications including postembolization syndrome, postprocedure pain, infection, endometrial atrophy leading to secondary amenorrhea, and uterine necrosis. Uterine necrosis after UAE is very rare and hence poses a clinical dilemma for any clinician in its identification and management. We document a case of uterine necrosis after UAE and conduct a literature review on its causation, clinical features, and management principles. A patient presented one month after UAE with abdominal pain and abdominal vaginal discharge. Her work-up revealed features of possible uterine necrosis with sepsis and she was scheduled for a laparotomy and a subtotal hysterectomy was performed. She was subsequently managed with broad spectrum antibiotic and recovered well. Uterine necrosis after UAE is a rare occurrence and we hope the documentation of this case will add to the body of knowledge around it. Theories that explain its occurrence include the use of small particles at embolization, the use of Contour-SE a spherical poly-vinyl alcohol, and lack of collateral supply to the uterus. Its symptoms may be nonspecific bu...Continue Reading

References

Jul 1, 1997·Journal of Vascular and Interventional Radiology : JVIR·S C GoodwinR Perrella
Sep 11, 2004·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Lior LöwensteinAmnon Amit
Jan 25, 2005·BJOG : an International Journal of Obstetrics and Gynaecology·Géraldine PorcuMarc Gamerre
Jun 11, 2008·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Blandine CourbiereMarc Gamerre
Jun 13, 2008·Best Practice & Research. Clinical Obstetrics & Gynaecology·Aradhana Khaund, Mary Ann Lumsden
Dec 18, 2008·Acta Obstetricia Et Gynecologica Scandinavica·Lauréne CoulangeHervé Tixier
Aug 13, 2013·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Olivier PoujadeDominique Luton
Dec 4, 2014·Cardiovascular and Interventional Radiology·Hans van Overhagen, Jim A Reekers
Dec 30, 2014·The Cochrane Database of Systematic Reviews·Janesh K GuptaMartha Hickey

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Citations

Jun 18, 2020·Medicina·Guglielmo StabileGiuseppe Ricci
Oct 2, 2019·The British Journal of Radiology·Parker E LudwigJoseph M Stavas

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Methods Mentioned

BETA
X-ray
hysterectomy
lavage

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