ABSTRACT
Post-partum haemorrhage remains a major cause of maternal mortality. Surgical management may be needed in patients with hemodynamic instability. Arterial embolization may be needed in case of persisting haemorrhage despite initial surgical management. We report a case of buttock necrosis occurring after pelvic embolization to control refractory post-partum haemorrhage and failed subtotal hysterectomy with bilateral internal iliac arteries ligation. To the best of our knowledge, this is the first case of buttock necrosis complicating a severe post-partum haemorrhage reported in the literature.
Subject(s)
Buttocks/pathology , Iliac Artery/surgery , Postoperative Complications/pathology , Postpartum Hemorrhage/surgery , Uterine Artery Embolization/adverse effects , Adult , Female , France , Humans , Hysterectomy , Iliac Artery/pathology , Ligation , Necrosis , Postoperative Complications/diagnosis , Postpartum Hemorrhage/pathology , Thrombocytopenia/pathologySubject(s)
Duodenum/injuries , Duodenum/surgery , Intestinal Perforation/surgery , Wounds, Penetrating/surgery , Child , Humans , MaleABSTRACT
We report a case of delayed post-conization hemorrhage induced by the rupture of a uterine artery false aneurysm. Cold knife conization of the cervix was the main cause of the false aneurysm. To our knowledge, this is the first case reported. Angiography enabled the diagnosis and the treatment by embolization of the lesion. A less aggressive technique than a scalpel, perhaps with a diathermic loop, could help to prevent this type of complication.
Subject(s)
Aneurysm, False/etiology , Conization/adverse effects , Postoperative Complications/etiology , Uterine Hemorrhage/etiology , Adult , Cervix Uteri/pathology , Female , Humans , Time FactorsABSTRACT
Laparoscopic hysterectomy is an efficient alternative to vaginal hysterectomy when the vaginal approach is difficult. In patients presenting very large uterus or large lateral myomas, the primary uterine arteries coagulation at their origins allow a safe laparoscopic hysterectomy. We report this surgical procedure carried out without incidents in three cases when uterus weighed more than 700 g and suggest the primary uterine arteries approach by retrograde umbilical tracking in large benign uterus.