Spontaneous Rupture of an Ovarian Artery Aneurysm: A Rare Postpartum Complication

Background. Spontaneous rupture of an ovarian artery aneurysm is a rare but usually life-threatening event. It is most often associated with pregnancy or fibroids. Our case followed a normal vaginal delivery and then a delayed presentation with features similar to other less life-threatening postpartum conditions. The diagnosis could have been missed but for the meticulous and timely interventions which avoided catastrophic outcome.Case. This is a case of a multiparous woman with rupture of a left ovarian artery aneurysm, causing massive retroperitoneal hemorrhage and hematoma that required a combination of arterial embolization, percutaneous CT scan guided drainage, and surgical evacuation of the hematoma.Conclusion. Spontaneous rupture of ovarian artery should be considered as one of the differential diagnoses in the immediate postpartum period especially when the clinical symptoms do not correlate with the amount of blood loss. A high index of suspicion, prompt diagnosis, intervention, and a multidisciplinary approach in the management were the elements of a successful outcome in this case.

Download Full-text

Postpartum spontaneous rupture of ovarian artery aneurysm

Journal of the American College of Emergency Physicians ◽

10.1016/s0361-1124(77)80020-8 ◽

1977 ◽

Vol 6 (9) ◽

pp. 432

Keyword(s):

Spontaneous Rupture ◽

Artery Aneurysm ◽

Ovarian Artery

Download Full-text

Spontaneous Rupture of Renal Metastasis from Hepatocellular Carcinoma

Case Reports in Surgery ◽

10.1155/2017/8607061 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Osamu Kinoshita ◽

Yusuke Ichijo ◽

Masayuki Yoneda ◽

Atsushi Ikai ◽

Tetsuro Yamashita

Keyword(s):

Hepatocellular Carcinoma ◽

Spontaneous Rupture ◽

Arterial Embolization ◽

Detailed Examination ◽

Retroperitoneal Space ◽

Retroperitoneal Hemorrhage ◽

Renal Metastasis ◽

Hospitalization Period ◽

Acute Back Pain ◽

The Right

We report a rare life-threatening case of spontaneous rupture of renal metastasis from hepatocellular carcinoma (HCC) that was managed by emergent transcatheter arterial embolization (TAE). A 76-year-old woman diagnosed with HCC presented with acute back pain in her right side and was transferred to our hospital. Initial enhanced computed tomography revealed retroperitoneal hemorrhage from the right kidney, which was retrospectively diagnosed as a spontaneous rupture of the metastatic renal tumor from the primary HCC. Detailed examination identified an active retroperitoneal hemorrhage from the lesion and the patient’s condition became hemodynamically unstable; hence emergent TAE was performed. The hospitalization period after the TAE was uneventful and sorafenib was subsequently administered. Unfortunately, two months after the TAE, the tumor locally progressed within the retroperitoneal space. Tumors were controlled by repeated TAE as the patient did not want to undergo a nephrectomy. Consequently, she survived for more than one year after emergent TAE, exhibiting low levels of tumor marker. After rupture of the metastatic renal HCC, tumors were expected to progress into the retroperitoneal space, and nephrectomy was the next possible radical treatment to offer the best chance of long-term disease control.

Download Full-text

Transcatheter Arterial Embolization as Treatment for a Life-Threatening Retroperitoneal Hemorrhage Complicating Heparin Therapy

The Korean Journal of Internal Medicine ◽

10.3904/kjim.2011.26.3.352 ◽

2011 ◽

Vol 26 (3) ◽

pp. 352 ◽

Cited By ~ 7

Author(s):

Sang-Ho Park ◽

Se-Whan Lee ◽

Ung Jeon ◽

Min-Hyeok Jeon ◽

Seung-Jin Lee ◽

...

Keyword(s):

Transcatheter Arterial Embolization ◽

Arterial Embolization ◽

Heparin Therapy ◽

Retroperitoneal Hemorrhage ◽

Life Threatening

Download Full-text

Urgent arterial embolization of ruptured renal angiomyolipoma

Open Medicine ◽

10.1515/med-2015-0035 ◽

2015 ◽

Vol 10 (1) ◽

Author(s):

Selim Kervancioglu ◽

Feyza Yilmaz

Keyword(s):

Transarterial Embolization ◽

Arterial Embolization ◽

Renal Angiomyolipoma ◽

Tumor Rupture ◽

Retroperitoneal Hemorrhage ◽

Life Threatening

AbstractThe most undesired complication of renal angi- omyolipoma (AML) is bleeding. Because of tumor rupture, the bleeding can spread to the retroperitoneal field and can be severe enough to be life threatening. We report a case of retroperitoneal hemorrhage caused by a ruptured AML that was successfully treated with transarterial embolization with N-butyl cyanoacrylate.

Download Full-text

Spontaneous Rupture of an Ovarian-Artery Aneurysm in the Third Trimester of Pregnancy

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.3109/00016348909013287 ◽

1989 ◽

Vol 68 (7) ◽

pp. 651-652 ◽

Cited By ~ 15

Author(s):

C. K. Høgdall ◽

S. J. Pedersen ◽

B. Ø. øvlisen ◽

U. J. V. Helgestrand

Keyword(s):

Spontaneous Rupture ◽

Artery Aneurysm ◽

Third Trimester ◽

Ovarian Artery ◽

The Third

Download Full-text

Spontaneous rupture of a splenic artery aneurysm during the third trimester of pregnancy

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2016-0054 ◽

2017 ◽

Vol 6 (1) ◽

Author(s):

Nuri Peker ◽

Nazif Harun Vicdanlı ◽

Ahmet Demir ◽

Mehmet Buğra Bozan ◽

Savaş Gündoğan

Keyword(s):

Maternal Death ◽

Spontaneous Rupture ◽

Splenic Artery ◽

Strong Association ◽

Hypovolemic Shock ◽

Artery Aneurysm ◽

Splenic Artery Aneurysm ◽

Third Trimester ◽

Life Threatening ◽

Threatening Situation

Abstract Spontaneous rupture of a splenic artery aneurysm (SAA) during pregnancy is a rare but life-threatening situation typically presenting with sudden and unexpected fetal and maternal death. The etiology is unclear; however, there is a strong association between pregnancy and the rupture of a SAA. Maternal and fetal prognosis is poor and mortality rates remain at 70% and 90%, respectively. Here, we present a case report of the spontaneous rupture of a SAA at the 35th week of gestation, which presented as suddenly developed hypovolemic shock ending in fetal and maternal death.

Download Full-text

Uterine pseudoaneurysm on the basis of deep infiltrating endometriosis during pregnancy-a case report

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03753-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tibor Andrea Zwimpfer ◽

Cécile Monod ◽

Katharina Redling ◽

Heike Willi ◽

Martin Takes ◽

...

Keyword(s):

Clinical Symptoms ◽

Arterial Embolization ◽

Symptomatic Patient ◽

Interdisciplinary Treatment ◽

Fetal Mortality ◽

Deep Infiltrating Endometriosis ◽

Increased Risk ◽

Risk Of Rupture ◽

Life Threatening ◽

Infiltrating Endometriosis

Abstract Background Pseudoaneurysm of the uterine artery (UPA) is a rare cause of potentially life-threatening hemorrhage during pregnancy and puerperium. It is an uncommon condition that mainly occurs after traumatic injury to a vessel following pelvic surgical intervention, but also has been reported based on underlying endometriosis. There is an increased risk of developing UPA during pregnancy. Diagnosis includes clinical symptoms, with severe abdominal pain and is confirmed by sonographic or magnetic resonance imaging (MRI). Due to its potential risk of rupture, with a subsequent hypovolemic maternal shock and high fetal mortality, an interdisciplinary treatment should be considered expeditiously. Case presentation We present the case of a 34-year old pregnant symptomatic patient, where a large UPA was detected at 26 weeks, based on deep infiltrating endometriosis (DIE). The UPA was successfully treated by selective arterial embolization. After embolization, the pain decreased but the woman still required intravenous analgesics during follow-up. At 37 weeks she developed a sepsis from the intravenous catheter which led to a cesarean section and delivery of a healthy boy. She was discharged 10 days postpartum. Conclusions UPA should be considered in pregnant women with severe abdominal and pelvic pain, once other obstetrical factors have been excluded. DIE might be the underlying diagnosis. It is a rare but potentially life-threatening condition for mother and fetus.

Download Full-text