Moriyama Taiki, Kodama Hiroshi, Taniguchi Junichi, Kinota Naoya, Maruyama Mitsunari, Ogasawara Atsushi, Kako Yasukazu, Takaki Haruyuki, Kobayashi Kaoru, Nitta Sho, Hasegawa Kana, Shirai Kunihiro, Takimoto Yumi, Sugiyama Yukiko, Tsubamoto Hiroshi, Yamakado Koichiro
Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan.
Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Interv Radiol (Higashimatsuyama). 2021 Nov 1;6(3):108-111. doi: 10.22575/interventionalradiology.2021-0003.
We describe the case of a 48-year-old woman who presented with traumatic rupture of a giant leiomyoma and massive hemoperitoneum caused by slipping and falling in the bathroom. She was in shock on arrival, and resuscitation was performed. Contrast-enhanced computed tomography showed massive intra-abdominal hematoma and extravasation from the subserous leiomyoma. Uterine artery embolization was performed, but she went into shock again after 6 h. The second contrast-enhanced computed tomography revealed persistence of extravasation. During 2 UAE, an angiogram revealed extravasation originating from left round ligament artery. After the embolization of the left round ligament and bilateral uterine arteries, the patient recovered from shock. Total abdominal hysterectomy was performed on day 2 of admission to prevent re-bleeding and infection, then she discharged on day 19 of admission.
我们描述了一例48岁女性的病例,该患者因在浴室滑倒导致巨大平滑肌瘤创伤性破裂并出现大量腹腔积血。她入院时处于休克状态,随即进行了复苏。增强计算机断层扫描显示腹腔内大量血肿以及浆膜下平滑肌瘤有造影剂外渗。进行了子宫动脉栓塞术,但6小时后她再次休克。第二次增强计算机断层扫描显示造影剂外渗持续存在。在两次子宫动脉栓塞术期间,血管造影显示造影剂外渗源自左圆韧带动脉。在栓塞左圆韧带和双侧子宫动脉后,患者休克症状缓解。入院第2天进行了全腹子宫切除术以防止再次出血和感染,随后于入院第19天出院。