Eboué C, Barjot P, Huet H, Jeanne-Pasquier C, Herlicoviez M
Service de Gynécologie Obstétrique et de Biologie de la Reproduction, CHU de Caen, Boulevard Georges-Clémenceau, Caen Cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2007 May;36(3):298-301. doi: 10.1016/j.jgyn.2006.12.024. Epub 2007 Feb 20.
We report here the case of a young woman who presented with pain, fever and apparent cutaneous sub ischaemia following embolisation of the uterine arteries for postpartum haemorrhagia. This embolisation was carried out by bilateral selective catheterism of the uterine arteries using 45 to 150 micron polyvinyl alcohol particles. Investigative laparotomy was decided in view of the persistence of the symptoms, and the patient underwent hysterectomy with ablation of the right adnexa to treat uterine necrosis and adnexal atrophy. Because of the information that we have actually, we can explain that this complication is linked with the use of polyvinyl alcohol small size particles. The migration of those embolisation agents might be responsible for obliteration of a large number of distal vessels. Those embolisation agents must, because of recommendation for good practice published in 2004, be reserved to exceptional cases to minimize the complication of embolisation.
我们在此报告一例年轻女性病例，该患者因产后出血接受子宫动脉栓塞术后出现疼痛、发热及明显的皮肤局部缺血。此次栓塞是通过双侧选择性子宫动脉插管，使用45至150微米的聚乙烯醇颗粒进行的。鉴于症状持续存在，决定进行剖腹探查术，患者接受了子宫切除术及右侧附件切除术，以治疗子宫坏死和附件萎缩。根据我们现有的信息，我们可以解释这种并发症与使用小尺寸聚乙烯醇颗粒有关。这些栓塞剂的迁移可能导致大量远端血管闭塞。根据2004年发布的良好操作建议，这些栓塞剂必须仅用于特殊情况，以尽量减少栓塞并发症。
