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Case Reports
. 2022 Jan 12;7(1):26-29.
doi: 10.22575/interventionalradiology.2021-0002. eCollection 2022 Mar 1.

Two Case Studies on Inferior Mesenteric Artery Embolization for Primary Postpartum Hemorrhage

Naoki Kawakami  1 , Fumiya Uchiyama  1 , Akinori Harada  1 , Tetsuhisa Yamada  1 , Jun-Ichi Nishimura  1
Affiliations
Case Reports

Two Case Studies on Inferior Mesenteric Artery Embolization for Primary Postpartum Hemorrhage

Naoki Kawakami et al. Interv Radiol (Higashimatsuyama). .

Abstract

Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality. Transcatheter arterial embolization (TAE) is an effective treatment option for PPH. Among the vessels embolized, the inferior mesenteric artery (IMA) is usually not the first choice for TAE, because it is a rare source of bleeding in PPH. In this report, we describe our experience with two patients with PPH, in whom the IMA was selected on the basis of contrast-enhanced computed tomography (CECT) findings, and prompt hemostasis was achieved with TAE. CECT can provide useful clues as to the culprit artery based on the anatomical location of the hematoma and extravasation. These useful findings of CECT allow prompt TAE of rare sources of bleeding in PPH, such as the IMA.

Keywords: Contrast-enhanced computed tomography; Inferior mesenteric artery; Postpartum hemorrhage.

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Conflict of interest statement

None

Figures

Figure 1.
Figure 1.
A. Abdominal contrast-enhanced computed tomography (CECT) on admission showing a large hematoma near the left vaginal wall (white arrow) and extravasation from the superior rectal artery (red arrow). B. Curved planar reconstruction (CPR) images showing extravasation from the superior rectal artery (red arrow).
Figure 2.
Figure 2.
A (RAO 30°). Angiogram of the inferior mesenteric artery (IMA) before transcatheter arterial embolization (TAE) showing extravasation from the superior rectal artery (red arrow). B (AP 0°). Successful TAE was performed with five metallic coils: angiogram of the IMA showing no extravasation (red arrow).
Figure 3.
Figure 3.
A. Abdominal CECT on the day of delivery showing extravasation from the superior rectal artery (red arrow). B. CPR images showing extravasation from the superior rectal artery (red arrow).
Figure 4.
Figure 4.
A (AP 0°). Angiogram of the IMA showing extravasation from the superior rectal artery (red arrow). B (AP 0°). Angiogram of the IMA after TAE with autologous thrombus showing no extravasation (red arrow).
See this image and copyright information in PMC

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