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宫腔镜手术所致子宫动脉假性动脉瘤及时诊断与干预的重要性。

Importance of timely diagnosis and intervention in uterine artery pseudoaneurysm caused by hysteroscopic surgery.

作者信息

Okpete Uchenna E, Byeon Haewon

机构信息

Department of Digital Anti-aging Healthcare (BK21), Inje University, Gimhae 50834, South Korea.

出版信息

World J Clin Cases. 2024 Dec 6;12(34):6740-6743. doi: 10.12998/wjcc.v12.i34.6740.

Abstract

This manuscript explores the case on the occurrence of uterine artery pseudoaneurysm (UAP) during hysteroscopy endometrial polypectomy and the subsequent successful treatment uterine artery embolization (UAE). Moreover, we focus on the management and treatment options for UAP in patients of advanced maternal age. A pseudoaneurysm is an extraluminal blood collection with a disrupted flow that communicates with the parent vessel a defect in the arterial wall. The reported case involved a 48-year-old primiparous woman who developed a UAP after uterine polyp removal. The study enhances the understanding of UAP, a rare but potentially life-threatening condition, by providing a detailed and well-documented account of the comprehensive case presentation, effective use of medical imaging techniques for diagnosis, successful postoperative patient management following UAE, and practical clinical recommendations for clinicians managing similar cases. Overall, this study highlights the importance of considering UAP as a differential diagnosis in patients with abnormal vaginal bleeding following hysteroscopic surgery. Additionally, this manuscript recommends that clinicians with a high index of suspicion for UAP promptly request ultrasonography and computed tomography to facilitate early diagnosis. UAE is suggested as a primary treatment due to its effectiveness and safety, particularly in facilities capable of avoiding hysterectomy.

摘要

本文探讨了宫腔镜子宫内膜息肉切除术中发生子宫动脉假性动脉瘤(UAP)及随后成功进行子宫动脉栓塞术(UAE)的病例。此外,我们重点关注高龄产妇UAP的管理和治疗选择。假性动脉瘤是一种管腔外血液聚集,血流中断并与母血管相通,即动脉壁存在缺损。报告的病例是一名48岁初产妇,在子宫息肉切除后发生了UAP。该研究通过详细且有充分记录的综合病例呈现、有效利用医学成像技术进行诊断、UAE术后成功的患者管理以及为处理类似病例的临床医生提供实用的临床建议,增强了对UAP这种罕见但可能危及生命的疾病的理解。总体而言,本研究强调了在宫腔镜手术后出现异常阴道出血的患者中,将UAP作为鉴别诊断的重要性。此外,本文建议对UAP高度怀疑的临床医生应及时要求进行超声检查和计算机断层扫描以促进早期诊断。由于UAE的有效性和安全性,特别是在有能力避免子宫切除术的机构中,建议将其作为主要治疗方法。

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