scholarly journals Ruptured pyomyoma – Rare complication of post-uterine artery embolization: A case report

2021 ◽  
Vol 11 ◽  
pp. 67
Author(s):  
Sai Swarupa Reddy Vulasala ◽  
Dheeraj Reddy Gopireddy ◽  
Khaled Mohamed ◽  
Chandana Lall
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Rare Complication ◽  
Invasive Procedure ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Vascular Supply ◽  
High Morbidity ◽  
Artery Embolization ◽  
Uterine Arteries

Leiomyomas, also termed as fibroids, are benign smooth, muscle neoplasms seen in 70–80% of women by the age of 50 years. Uterine artery embolization (UAE) is a minimally invasive procedure that involves cessation of vascular supply to the fibroids, by infusion of gelatinous microspheres into the uterine arteries. Pyomyoma is a suppurative leiomyoma, secondary to infection of necrotic tissue. It is an infrequent complication of uterine artery embolization (UAE). Pyomyoma can lead to sepsis, peritonitis, and respiratory distress syndrome resulting in high morbidity and mortality. Due to its rarity, high suspicion is crucial in the diagnosis, and prompt treatment is recommended to reduce mortality. Ultrasound, computed tomography, and magnetic resonance imaging assist in diagnosis. We present a case of a 44-year-old woman with ruptured pyomyoma, following an UAE intervention. The patient was treated with total abdominal hysterectomy and salpingo-oophorectomy along with peritoneal irrigation and drainage.

Structural changes in uterine tissues after uterine artery embolization in patients with leiomyoma complicated by uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 78-82
Author(s):  
G P Titova ◽  
M M Damirov ◽  
L S Kokov ◽  
O N Oleynikova ◽  
G E Belozerov
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Structural Changes ◽  
Morphological Changes ◽  
Uterine Bleeding ◽  
Small Scale ◽  
Artery Embolization ◽  
Vessel Occlusion ◽  
Uterine Arteries ◽  
Uterine Tumors

Uterine leiomyoma (UL) is often complicated by the development of uterine bleeding. In urgent gynecology for the implementation of endovascular hemostasis, uterine artery embolization (UAE) is used. Performing UAE allows to stop and/or significantly reduce the intensity of bleeding and prepare a patient for surgical intervention. At the same time, the morphological changes that occur in uterine tissues in operated UL patients after performing the UAE are not studied. The aim was to study the peculiarities of pathomorphological changes in uterine tumors and tissues in operated UL patients complicated by uterine bleeding after performing UAE. Material and methods. The results of morphological changes appearing in tumors and tissues of the uterus in 39 operated UL patients, who were used for stopping uterine bleeding, were analyzed. Results. After applying different types of embolizing agents in macroscopic study of the uterus, signs of ischemia of its tissues were revealed, and the most pronounced disorders were detected in the UL nodes. Morphologically it was established that UAE microemboli resulted in vessel occlusion with increasing thrombosis in their distal sections. UAE was not accompanied by occlusal occlusion of the arteries and resulted in small-scale necrosis of the tumor with complete regeneration of the endometrium. Conclusions. The results of the morphological study showed that after the UAE was performed, the myomatous nodes underwent dystrophic, necrobiotic and necrotic changes. Depending on the nature of occlusion of the uterine arteries, various variants of necrosis (scale and completeness of the process) developed in the tumor tissue, which was aseptic in nature.

scholarly journals Management of single submucosal fibroid in unmarried females with uterine artery embolization

2020 ◽  
Vol 9 (2) ◽  
pp. 774
Author(s):  
Sunil Kumar Juneja ◽  
Gagandeep Kaur ◽  
Muskan Chaudhary
Keyword(s):  
Minimally Invasive ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Symptomatic Relief ◽  
Invasive Procedure ◽  
Benign Neoplasm ◽  
Menstrual Bleeding ◽  
Invasive Technique ◽  
Artery Embolization ◽  
Gnrh Analogues

Background: Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis. The location of fibroids, whether submucosal, subserosal, pedunculated subserosal, intramural, or endocavitary, is important because signs and symptoms may be determined by location. Uterine artery embolization (UAE) for many patients is an effective alternative treatment to surgical therapy for fibroid tumors. It is a minimally invasive procedure, which allows for rapid recovery and return to normal activities. Objective of this study was to know the efficacy of minimally invasive technique UAE for reducing symptoms in sub-mucous uterine leiomyoma in unmarried females.Methods: This retrospective analysis was performed on 9 unmarried females with symptomatic single submucosal fibroid diagnosed on MRI with size range of 3.5 cms to 6.5 cms. They presented at Dayanand Medical College and Hospital, Ludhiana, Punjab in a period of 3 years from January 2016-December 2019. Inclusion criteria were unmarried females, single submucosal fibroid diagnosed on USG/MRI. Exclusion criteria was active infection, more than one fibroid in uterus, prior GnRH analogues treatment during the previous 3 months.Results: All patients presented with heavy menstrual bleeding (HMB) and dysmenorrhea, lower abdomen pain was encountered in 3 patients and 2 patients had inter-menstrual bleeding. Recurrent, UTI was there in 1 patient and 1 patient had vaginal discharge. All fibroids belonged to stage 1 FIGO classification. UAE was done and patients were followed for 6 months. Symptomatic success was seen in 100% patients and 77.77% patients expelled the fibroid per vaginally.Conclusions: UAE is alternative method of treatment for submucosal fibroids in unmarried females who do not want to undergo surgery. Proper case selection can give us good results and symptomatic relief.

scholarly journals Successful repeated uterine artery embolization in postpartum hemorrhage with disseminated intravascular coagulation: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shunya Sugai ◽  
Taro Nonaka ◽  
Kana Tamegai ◽  
Tatsuhiko Sato ◽  
Kazufumi Haino ◽  
...  
Keyword(s):  
Risk Factor ◽  
Disseminated Intravascular Coagulation ◽  
Postpartum Hemorrhage ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Placenta Previa ◽  
Blood Transfusions ◽  
Artery Embolization ◽  
Intravascular Coagulation ◽  
Uterine Arteries

Abstract Background Postpartum hemorrhage (PPH) is a potentially fatal condition requiring urgent and appropriate intervention. Uterine artery embolization (UAE) has a high hemostatic capacity for PPH, but it may fail. Disseminated intravascular coagulation (DIC) has been reported as a risk factor associated with the failure of UAE. Case presentation A 37-year-old primigravida with dichorionic diamniotic twins and placenta previa underwent cesarean section. The blood loss during surgery was 4950 mL. Hemostasis was achieved using an intrauterine balloon tamponade device. However, she lost a further 2400 mL of blood 5 h after surgery. We embolized both uterine arteries using gelatin sponges and confirmed hemostasis. She was suffering from DIC and received ample blood transfusions. However, a further 1300 mL of blood was lost 18 h after surgery and we performed repeated UAE, with complete recanalization of the uterine arteries on both sides and re-embolization with gelatin sponges. Her DIC was treated successfully by blood transfusions at this time, and she showed no further bleeding after the repeated UAE. Conclusions DIC is a risk factor for the failure of UAE. Repeated UAE may be effective after sufficient improvement of the hematological status in patients with PPH and DIC.

scholarly journals Uterine Artery Embolization End Points and Collateral Circulation: Value of Intra-Procedural Non-Contrast Cone Beam CT

2021 ◽  
Vol 9 (3) ◽  
Author(s):  
Jaron Tepper ◽  
Jacob Cynamon
Keyword(s):  
Blood Supply ◽  
Collateral Circulation ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Cone Beam Ct ◽  
Uterine Fibroids ◽  
Cone Beam ◽  
Artery Embolization ◽  
Embolic Material ◽  
Uterine Arteries

Uterine artery embolization (UAE) is a well-accepted treatment for symptomatic uterine fibroids, but endpoints of UAE remain controversial. This is of significant concern as incomplete embolization can lead to treatment failure, necessitating repeat embolization or alternative treatments such as hysterectomy. Multiple potential causes of UAE failure have been described including failure to catheterize one or both of the uterine arteries, uterine artery spasm, clumping of embolic material and collateral blood supply vascularizing the fibroids. In this review, we discuss potential approaches to identifying collateral blood supply to the uterus and suggest that intra-procedural non-contrast cone beam CT provides unique advantages to addressing this issue.

scholarly journals Repeated broad ligament hematomas managed by uterine artery embolization: time to execute

2019 ◽  
Vol 8 (8) ◽  
pp. 3417
Author(s):  
Subrat Panda ◽  
Nalini Sharma ◽  
Pranjal Phukan
Keyword(s):  
Complication Rate ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Effective Interaction ◽  
Broad Ligament ◽  
Arterial Embolization ◽  
Clinical Effectiveness ◽  
Artery Embolization ◽  
Uterine Arteries ◽  
Obstetric Haemorrhage

Selective arterial embolization (SAE) of the uterine arteries is an alternative to surgery when medical management fails in cases of intractable posrtpartum haemorrhage. It is highly efficacious with low complication rate. Here we report a case of repeated broad ligament haematoma managed by selective uterine artery embolization. Present case 28year old P4L4 was referred from a district hospital as post LSCS case with broad ligament haematoma. Patients general condition was very poor at the time of admission. She underwent laparotomy twice and finally uterine artery embolization for repeated broad ligament haematoma and responded. Massive obstetric haemorrhage remains a significant cause of maternal morbidity and mortality. The threshold for uterine artery embolization (UAE) in women with obstetric haemorrhage should be low, as it is coupled with a high clinical effectiveness rate, low complication rate and preservation of fertility. However, it requires an infrastructure, multidisciplinary approach, as well as speedy and effective interaction between various specialties.

scholarly journals Myoma Expulsion after Uterine Artery Embolization

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Vivian Fernanda do Amaral ◽  
Fernanda Yumi Yochiy ◽  
Mário Luiz Furlanetto ◽  
Spencer Luiz Marques Payão
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Treatment Strategies ◽  
Invasive Procedure ◽  
Uterine Leiomyomas ◽  
Artery Embolization ◽  
Pelvic Tumors ◽  
History Of ◽  
Efficient Alternative ◽  
Promising Treatment

Introduction. Uterine leiomyomas are the most common benign pelvic tumors in women over 35 years and can be symptomatic or asymptomatic. Among the main treatment strategies, there are hormone therapy, hysterectomy, myomectomy, and uterine artery embolization (UAE), a recent and promising treatment for patients who wish to avoid hysterectomy. Ideal candidates for UAE are women with symptomatic uterine leiomyomas that present no desire for pregnancy, premenopausal and heavy menstrual bleeding, or dysmenorrhea caused by intramural fibroids. Case Presentation. A 36-year-old female diagnosed with leiomyomas and an extensive history of failed previous treatments who, in order to preserve her uterus, underwent UAE and had tumor expulsion 15 days after the procedure. The patient remained eight months in amenorrhea and, currently, presents normal hormone levels and irregular periods. Conclusion. UAE presents itself as a minimally invasive procedure and as an efficient alternative for those patients who wish to preserve their uteri and also improve their symptoms and quality of life.

scholarly journals Uterine artery embolization in the treatment of submucous myomatous nodes

2020 ◽  
Vol 15 (2) ◽  
pp. 107-114
Author(s):  
Dulat Tazhibayev ◽  
◽  
Bakhyt Abishev ◽  
Irina Kamyshanskaya ◽  
Makash Aliyakparov ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Common Disease ◽  
Women Of Reproductive Age ◽  
Artery Embolization ◽  
X Ray ◽  
Uterine Arteries ◽  
Endovascular Occlusion

The purpose of the article was to evaluate trends of uterine submucousal myomas after the embolization of uterine arteries. Uterine fibroids are a common disease in women of reproductive age, accounting for 10 to 30 %, according to various authors. The submucous location of the myomatous node is an unfavorable type of localization of fibroids since it almost always requires surgical treatment. In this work, we would like to report on the results of endovascular x-ray occlusion of the uterine arteries in the treatment of submucous myomatous nodes. Percutaneous through catheter occlusion of uterine arteries with submucousal myomatous nodes was performed in 21 patients where 18 of them through the femoral, and 3 of them through beam access. The patients’ age was under 32 up to 47 with average 36,5. Myomatous nodes’ size is from 3,0 till 9,0 centimeters. There were noted self-expulsions of 10 from 21 submucousal myomatous nodes after X-ray endovascular occlusion during the 7 days and until 3 months. In the gynecological department they performed removal of partially born submucosal nodes in 3 out of 21 patients within 3 months. In the remaining 8 of 21 observations (381 %), submucosal nodes underwent myolysis in the following 12 months. After X-ray endovascular occlusion there might be expulsion or myolysis of myoma nodes in different terms during the submucosal myomatous of uterine.

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