Wallach William J, Mohamed Ahmed-Zayn, Hoots Glenn, Lu Samuel, Zwiebel Bruce
University of South Florida College of Medicine, 112 N 12th St, Tampa, FL 33602, USA.
Department of Interventional Radiology, Tampa General Hospital, Tampa, FL, USA.
Radiol Case Rep. 2020 Sep 14;15(11):2319-2321. doi: 10.1016/j.radcr.2020.08.065. eCollection 2020 Nov.
We report a case of a uterine artery pseudoaneurysm in a 29-year-old primigravid woman at 16 weeks gestation. The woman presented to the emergency room with lower left quadrant pain and vaginal bleeding. Ultrasound revealed a left adnexal mass consistent with a pseudoaneurysm. Percutaneous thrombin injection was chosen to avoid contrast and radiation risks to the fetus. Ultrasound demonstrated thrombosis of the pseudoaneurysm with no evidence of fetal distress. On postprocedure day 2, the patient presented again with similar complaints of lower quadrant pain and vaginal bleeding. The pseudoaneurysm was found to have recanalized and a decision was made to treat with computed tomography angiography and coil embolization. The procedure was successful, with angiography revealing an incidental branch of the pseudoaneurysm that was subsequently embolized.
我们报告一例妊娠16周的29岁初孕妇子宫动脉假性动脉瘤病例。该名女性因左下象限疼痛和阴道出血就诊于急诊室。超声检查发现左侧附件区有一肿块,符合假性动脉瘤表现。为避免对胎儿造成造影剂和辐射风险,选择了经皮注射凝血酶治疗。超声显示假性动脉瘤血栓形成,未发现胎儿窘迫迹象。术后第2天,患者再次出现类似的下象限疼痛和阴道出血症状。发现假性动脉瘤已再通,决定采用计算机断层血管造影和弹簧圈栓塞治疗。手术成功,血管造影显示假性动脉瘤有一意外分支,随后对其进行了栓塞。