Published online Sep 16, 2024. doi: 10.12998/wjcc.v12.i26.5968
Revised: June 19, 2024
Accepted: July 5, 2024
Published online: September 16, 2024
Processing time: 116 Days and 5 Hours
We report a case of uterine artery pseudoaneurysm (UAP) occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization (UAE).
A 48-year-old primigravid, primiparous patient was incidentally found to have an endometrial polyp during a health checkup, and underwent a hysteroscopic polypectomy at another hospital. Her cervix was dilated with a Laminken-R® device. After the Laminken-R® was withdrawn, a large amount of genital bleeding was observed. This bleeding persisted after the hysteroscopic polypectomy, and, as hemostasis became impossible, the patient was transferred to our hospital by ambulance. On arrival, transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus, and color Doppler ultrasonography showed feeder vessels penetrating the mass. Pelvic contrast-enhanced computed tomography (CT) confirmed the presence of a mass at this site, and vascular proliferation was observed within the uterine cavity. Consequently, UAP was diagnosed, and UAE was performed. The patient’s postoperative course was uneventful, and 6 mo post-UAE, no recurrence of blood flow to the UAP was observed.
When abnormal genital bleeding occurs during hysteroscopic surgery, ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs.
Core Tip: When abnormal uterine bleeding occurs after hysteroscopic surgery, the possibility of uterine artery pseudoaneurysm (UAP) must be considered. Confirmed UAP must be managed promptly and appropriately.