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剖宫产术后子宫动脉假性动脉瘤伴动静脉瘘:产后延迟出血的罕见但严重病因

Pseudo aneurysm of the uterine artery with arteriovenous fistula after cesarean section: A rare but sinister cause of delayed postpartum hemorrhage.

作者信息

Pohlan Julian, Hinkson Larry, Wickmann Ulrike, Henrich Wolfgang, Althoff Christian E

机构信息

Department of Radiology, Campus Charité Mitte, Berlin, Germany.

Department of Obstetrics, Charité Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.

出版信息

J Clin Ultrasound. 2021 Mar;49(3):265-268. doi: 10.1002/jcu.22890. Epub 2020 Jun 29.

Abstract

Pseudoaneurysm of the uterine artery is a rare complication of cesarean section. Delayed diagnosis and management may result in rapid and catastrophic postpartum hemorrhage and may necessitate hysterectomy or can even be fatal. A 28-year-old woman (gravida I, para I) presented with delayed postpartum hemorrhage 10 days after emergency cesarean section. Using transabdominal and transvaginal Color Doppler sonography, we detected a pseudoaneurysm in the posterior uterine wall, which was successfully treated with selective embolization distal and proximal to the lesion with platinum coils. In patients with delayed postpartum hemorrhage-especially after cesarean section-the rare possibility of uterine artery pseudoaneurysm must be kept in mind.

摘要

子宫动脉假性动脉瘤是剖宫产术后一种罕见的并发症。诊断和处理延迟可能导致产后迅速发生灾难性出血,可能需要行子宫切除术,甚至可能致命。一名28岁女性(孕1产1)在急诊剖宫产术后10天出现产后延迟性出血。通过经腹和经阴道彩色多普勒超声检查,我们在子宫后壁检测到一个假性动脉瘤,并使用铂金线圈对病变部位的远侧和近侧进行选择性栓塞,成功治愈。对于产后延迟性出血的患者,尤其是剖宫产术后的患者,必须考虑到子宫动脉假性动脉瘤这种罕见的可能性。

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