Journal List > J Korean Soc Radiol > v.74(4) > 1087650

TOOLS
Hong, Kim, and Kim: Spontaneous Pseudoaneurysm of the Uterine Artery during Pregnancy Treated by Direct Thrombin Injection: A Case Report
Uroradiology
Case Report

Journal of the Korean Society of Radiology 2016; 74(4): 263-266.

Published online: 25 March 2016

DOI: https://doi.org/10.3348/jksr.2016.74.4.263

Spontaneous Pseudoaneurysm of the Uterine Artery during Pregnancy Treated by Direct Thrombin Injection: A Case Report

Jung Hee Hong, MD, See Hyung Kim, MD, Young Hwan Kim, MD

Department of Radiology, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea.

Corresponding author: See Hyung Kim, MD. Department of Radiology, Keimyung University School of Medicine, Dongsan Medical Center, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea. Tel. 82-53-250-7770, Fax. 82-53-250-7766, kseehdr@dsmc.or.kr

Received 26 June 2015       Revised 19 October 2015       Accepted 4 November 2015

Copyright © 2016 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pseudoaneurysm of uterine artery during pregnancy is a very rare disease. It is mostly associated with uterine artery injury, usually occurring after proceeding conditions such as history of gynecologic operation and infection. However, the best treatment modality has not been established yet. Herein, we reported a case of spontaneous formation of uterine artery pseudoaneurysm during pregnancy treated by direct thrombin injection without any complication or recurrence.

Keywords: Pregnancy, Pseudoaneurysm, Ultrasound, Uterine Artery

Figures and Tables

Fig. 1

Color Doppler ultrasonography of the uterine lower corpus reveals a swirling flow within the anechoic mass (characteristic yin-yang pattern), compatible with uterine artery pseudoaneurysm.

jksr-74-263-g001
Fig. 2

Pelvic magnetic resonance imaging.

A. Axial T2-weighted image shows an about 45 × 28 mm sized hyperintense mass at the left lower corpus of uterus.
B, C. Axial T1-weighted images show a pseudoaneurysm originating from the left uterine artery (arrows).
jksr-74-263-g002
Fig. 3

Color Doppler ultrasound after the thrombin injection procedure reveals lack of flow in the pseudoaneurysm, suggestive of a completely thrombosed pseudoaneurysm.

jksr-74-263-g003
Fig. 4

After 2 weeks, follow up axial T1-weighted image shows a completely thrombosed uterine artery pseudoaneurysm without any other complications.

jksr-74-263-g004

References

1. Cornette J, van der Wilk E, Janssen NM, van der Weiden RM, Jenninkens SF, Pattynama P, et al. Uterine artery pseudoaneurysm requiring embolization during pregnancy. Obstet Gynecol. 2014; 123:2 Pt 2 Suppl 2. 453–456.
2. Matsubara S, Nakata M, Baba Y, Suzuki H, Nakamura H, Suzuki M. Uterine artery pseudoaneurysm hidden behind septic abortion: pseudoaneurysm without preceding procedure. J Obstet Gynaecol Res. 2014; 40:586–589.
3. Kovo M, Behar DJ, Friedman V, Malinger G. Pelvic arterial pseudoaneurysm-a rare complication of Cesarean section: diagnosis and novel treatment. Ultrasound Obstet Gynecol. 2007; 30:783–785.
4. Rahman S, Abdul-Waheed M, Helmy T, Huffman LC, Koshal V, Guitron J, et al. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography. J Cardiothorac Surg. 2009; 4:15.
5. Zegarac Z, Duić Z, Kukura V, Ramač JP, Skegro D, Skopljanac A. Pseudoaneurysm of the abdominal aorta in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2011; 156:235–236.
6. Gruber PJ, Askin FB, Heitmiller RF. Pulmonary artery aneurysm in a pregnant woman. Ann Thorac Surg. 2001; 71:1023–1025.
7. Matsubara S, Takahashi Y, Usui R, Nakata M, Kuwata T, Suzuki M. Uterine artery pseudoaneurysm manifesting as postpartum hemorrhage after uneventful second-trimester pregnancy termination. J Obstet Gynaecol Res. 2010; 36:856–860.
8. Nicolini A, Gaia G, Duiella SF, Ossola MW, Fedele L. Conservative treatment of giant uterine artery pseudoaneurysm. Ultrasound Obstet Gynecol. 2014; 43:602–604.
9. Lee TK, Jeon YS, Hong KC, Cho SG, Kim E. Balloon-assisted ultrasound-guided thrombin injection of a pseudoaneurysm in the posterior tibial artery: a case report. J Korean Soc Radiol. 2014; 70:325–329.
10. International Commission on Radiological Protection. Pregnancy and medical radiation. Ann ICRP. 2000; 30:iii–viii. 1–43.
TOOLS
Similar articles