Post-cesarean section pseudoaneurysm of uterine artery: A case report

• Published in: International journal of surgery case reports 2024-06, Vol.119, p.109697, Article 109697
• Main Authors: Poudel, Aashis, Thapa, Sabita, Giri, Aashish, Paudel, Ayushma, Sah, Abinash Kumar, Luitel, Sabin
• Format: Article
• Language: English
• Subjects: Cesarean section; Embolization; Postpartum hemorrhage; Pseudoaneurysm
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109697

Uterine artery pseudoaneurysm is an extraluminal collection of blood caused by damage to the arterial wall which can result from cesarean section, myomectomy, hysterectomy, laparoscopic excision of deep endometriotic lesions, dilation and curettage and uterine cervical conization. Uterine artery pseudoaneurysm may go unnoticed as a possible cause of post-partum hemorrhage. We report a case of 25 years female who presented with 3 episodes of per vaginal bleeding on the 34th postoperative day of cesarean section. Computed tomography angiogram confirmed the aneurysm of the left uterine artery and the artery was embolized for the management of aneurysm. Follow-up scan showed normal blood flow and her symptoms were relieved after the procedure. Uterine artery pseudoaneurysm can be diagnosed by Doppler ultrasound which shows intrauterine mass with swirling blood flow. The gold standard investigation is computed tomography angiography. Uterine artery embolization is the recent treatment approach which is both safe and effective. Women who present with postpartum vaginal bleeding should be promptly evaluated for uterine artery pseudoaneurysm. Uterine artery pseudoaneurysm can then be effectively managed through embolization, ensuring timely intervention and improved maternal health outcomes. •Uterine artery pseudoaneurysms are rare causes of postpartum hemorrhage.•CT angiography is the gold standard investigation for diagnosis.•Uterine artery pseudoaneurysm can be effectively managed through embolization.