Enakpene Christopher A, Stern Toni, Barzallo Salazar Marco J, Mukherjee Pradip
Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 S. Wood Street (MC 808), Chicago, IL 60612, USA; Department of Obstetrics and Gynecology, Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY 11235, USA.
Department of Obstetrics and Gynecology, Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY 11235, USA.
Case Rep Obstet Gynecol. 2016;2016:1029561. doi: 10.1155/2016/1029561. Epub 2016 Feb 29.
Background. Spontaneous rupture of an ovarian artery aneurysm is a rare but usually life-threatening event. It is most often associated with pregnancy or fibroids. Our case followed a normal vaginal delivery and then a delayed presentation with features similar to other less life-threatening postpartum conditions. The diagnosis could have been missed but for the meticulous and timely interventions which avoided catastrophic outcome. Case. This is a case of a multiparous woman with rupture of a left ovarian artery aneurysm, causing massive retroperitoneal hemorrhage and hematoma that required a combination of arterial embolization, percutaneous CT scan guided drainage, and surgical evacuation of the hematoma. Conclusion. Spontaneous rupture of ovarian artery should be considered as one of the differential diagnoses in the immediate postpartum period especially when the clinical symptoms do not correlate with the amount of blood loss. A high index of suspicion, prompt diagnosis, intervention, and a multidisciplinary approach in the management were the elements of a successful outcome in this case.
背景。卵巢动脉动脉瘤自发性破裂是一种罕见但通常危及生命的事件。它最常与妊娠或子宫肌瘤相关。我们的病例先是正常阴道分娩,之后出现类似其他不太危及生命的产后情况的延迟表现。若不是进行了细致及时的干预从而避免了灾难性后果,该诊断可能会被漏诊。病例。这是一例经产妇,左侧卵巢动脉动脉瘤破裂,导致大量腹膜后出血和血肿,需要联合进行动脉栓塞、经皮CT扫描引导下引流以及血肿手术清除。结论。卵巢动脉自发性破裂应被视为产后即刻阶段的鉴别诊断之一,尤其是当临床症状与失血量不相关时。高度的怀疑指数、及时诊断、干预以及多学科管理方法是该病例成功治疗的要素。