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Case Reports
. 2017 Jan-Mar;6(1):25-27.
doi: 10.1016/j.gmit.2016.04.002. Epub 2016 May 14.

Uterine artery pseudoaneurysm caused by a uterine manipulator

Toshiyuki Seki  1 , Yoshinobu Hamada  1 , Teppei Ichikawa  1 , Shin Onota  1 , Manabu Nakata  2 , Satoshi Takakura  1
Affiliations
Case Reports

Uterine artery pseudoaneurysm caused by a uterine manipulator

Toshiyuki Seki et al. Gynecol Minim Invasive Ther. 2017 Jan-Mar.

Abstract

A uterine artery pseudoaneurysm (UAP) can occur after a traumatic event to the uterus, and cause massive bleeding. A uterine manipulator has been widely used for gynecologic laparoscopic surgery as basically an atraumatic instrument. We describe here a woman with a UAP caused by a uterine manipulator. She underwent laparoscopic ovarian cystectomy with a uterine manipulator due to torsion of a left ovarian cyst. Eleven days later, she came to our hospital with massive vaginal bleeding. Transvaginal Color Doppler ultrasound showed an intrauterine cystic mass with swirling blood flow, and three-dimensional arterial imaging from computed tomography revealed a UAP on the left side. Selective uterine artery angiography demonstrated a pseudoaneurysm in the distal portion of the left uterine artery, and embolization was performed successfully. A UAP should be taken into consideration in uterine bleeding after the use of a uterine manipulator.

Keywords: laparoscopy; pseudoaneurysm; uterine artery; uterine manipulator.

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Conflict of interest statement

Conflicts of interest: All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Illustration of pseudoaneurysm formation.
Figure 2
Figure 2
(A) Grayscale ultrasound imaging showing a 1.5-cm anechoic lesion in the uterine cavity. (B) Color Doppler imaging showing swirling blood flow with a to-and-fro pattern in the intrauterine cystic lesion.
Figure 3
Figure 3
Three-dimensional computed tomography showing a pseudoaneurysm located at the distal end of the left uterine artery.
See this image and copyright information in PMC

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