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Case Reports
. 2021 Apr 30;92(S1):e2021157.
doi: 10.23750/abm.v92iS1.9559.

Conservative treatment for hypervascularised placental polyp with secondary haemoperitoneum: a case report

Maurizio Di Serio  1 , Vito Andrea Capozzi  2 , Roberto Berretta  3 , Carla Marcato  4 , Andrea Dall'Asta  5 , Tiziana Frusca  6
Affiliations
Case Reports

Conservative treatment for hypervascularised placental polyp with secondary haemoperitoneum: a case report

Maurizio Di Serio et al. Acta Biomed. .

Abstract

Objective: We describe the first case to our knowledge of Hypervascularised placental polyp (HPP) presenting with acute pelvic pain and hemoperitoneum.

Case report: A 33 years-old woman with a history of medical abortion three months earlier came to our attention complaining acute pelvic pain and vaginal bleeding. Transvaginal (TV) and transabdominal (TA) ultrasound (US) demonstrated a highly vascular intrauterine lesion and intra-abdominal free fluid consistent with a diagnosis of haemoperitoneum. Emergency laparoscopy yielded no intra-abdominal bleeding and was followed by bilateral selective embolization of the uterine arteries due to persistent vaginal bleeding. Hysteroscopy and pathology findings were consistent with a final diagnosis of HPP.

Conclusion: HPP may occur months or years after pregnancy or abortion and the clinical picture of abnormal vaginal bleeding associated with acute abdominal pain and haemoperitoneum should warrant to consider HPP among the differential diagnosis. Clinical and imaging findings need to be considered when planning the conservative management of HPP. Our experience suggests that uterine artery embolization is a safe and effective for the conservative treatment of highly vascularized HPP.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
Sonographic appearance of the hypervascularised placental polyp (HPP) at 2D transvaginal ultrasound (US). a) On 2D gray scale US the HPP appears as a iso/hyperechoic and inhomogeneous lesion located within the uterine cavity. b) High vascularity and deep extension within the uterine wall can be demonstrated at Color Doppler US.
Figure 2.
Figure 2.
Angiographic findings showing the hypervascularized intrauterine lesion, which is supplied by bilateral vascularization.
See this image and copyright information in PMC

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