Lounici Nazim, Cheifa Abdelouahab, Bendjama Oumaima, Maireche Ammar, Saadat Mohammed Rafiq, Seddiki Karima
Central Military Hospital, Ain Naadja, 16205, Algiers, Algeria.
Radiol Case Rep. 2024 Feb 23;19(5):1876-1880. doi: 10.1016/j.radcr.2024.01.076. eCollection 2024 May.
Postpartum hemorrhage caused by a pseudoaneurysm of the uterine artery is suspected clinically in the case of abundant metrorrhagia. An ultrasound is performed, followed by further imaging modalities to confirm the diagnosis: CT scan, MRI, and angiography, the latter would also allow embolization. This is admittedly rare, however, since the pseudo aneurysm of the uterine artery is potentially fatal, it must be taken into account in the differential diagnosis of secondary postpartum hemorrhage, allowing adequate and rapid management. We report a case of pseudo aneurysm of the uterine artery, suspected clinically and confirmed by a CT scan, presenting as a secondary postpartum hemorrhage a few hours after delivery by cesarean section. It was eventually managed by embolization with excellent results several days after its onset when the cause was revealed. Angiographic embolization is an effective treatment for postpartum hemorrhage caused by pseudoaneurysm in stable patients. It should be considered before surgery in suitable cases.
临床上，若出现大量子宫出血，则怀疑是由子宫动脉假性动脉瘤引起的产后出血。先进行超声检查，随后采用进一步的成像方式以确诊：CT扫描、MRI和血管造影，后者还可用于栓塞治疗。诚然，这种情况较为罕见，然而，由于子宫动脉假性动脉瘤有潜在致命风险，因此在继发性产后出血的鉴别诊断中必须予以考虑，以便进行充分且快速的处理。我们报告一例子宫动脉假性动脉瘤病例，临床怀疑并经CT扫描确诊，该病例表现为剖宫产术后数小时出现继发性产后出血。最终在发病数天后病因明确时通过栓塞治疗，效果良好。血管造影栓塞术是治疗稳定患者假性动脉瘤所致产后出血的有效方法。在合适的病例中，应在手术前考虑采用该方法。
