Kunishima Kanako, Takao Hidemasa, Kato Nobuyuki, Inoh Shinichi, Ohtomo Kuni
Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Radiat Med. 2008 Apr;26(3):168-70. doi: 10.1007/s11604-007-0208-5.
Nonpuerperal traumatic vulvar hematomas are relatively uncommon. Conservative and surgical management are the usual treatment options for traumatic vulvar hematomas. There is no report of transarterial embolization of nonpuerperal traumatic vulvar hematoma. We report a 35-year-old woman who presented with a vulvar hematoma caused by an accidental fall on a toy of her child. The hematoma was expanding and was refractory to conservative treatment. A computed tomography (CT) scan revealed active extravasation of contrast material from the left internal pudendal artery. We performed transarterial embolization of the left internal pudendal artery. The left external pudendal artery, which had an anastomosis with the left internal pudendal artery, was also embolized. Postembolization angiography demonstrated no further extravasation of contrast material. We believe that transarterial embolization can be an effective treatment of nonpuerperal traumatic vulvar hematomas when conservative treatment fails.
非产褥期创伤性外阴血肿相对少见。保守治疗和手术治疗是创伤性外阴血肿的常用治疗选择。目前尚无关于非产褥期创伤性外阴血肿经动脉栓塞治疗的报道。我们报告一名35岁女性，因意外摔倒在其孩子的玩具上而出现外阴血肿。血肿不断扩大，保守治疗无效。计算机断层扫描（CT）显示对比剂从左侧阴部内动脉活动性外渗。我们对左侧阴部内动脉进行了经动脉栓塞治疗。与左侧阴部内动脉有吻合的左侧阴部外动脉也进行了栓塞。栓塞后血管造影显示对比剂无进一步外渗。我们认为，当保守治疗失败时，经动脉栓塞可作为非产褥期创伤性外阴血肿的有效治疗方法。
