Uterine artery pseudoaneurysm caused by a uterine manipulator

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• 作者：Toshiyuki Seki^a ; Yoshinobu Hamada^a ; ^{y-hamada@dokkyomed.ac.jp} ; Teppei Ichikawa^a ; Shin Onota^a ; Manabu Nakata^b ; Satoshi Takakura^a
• 关键词：laparoscopy ; pseudoaneurysm ; uterine artery ; uterine manipulator
• 刊名：Gynecology and Minimally Invasive Therapy
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：6
• 期：1
• 页码：25-27
• 全文大小：473 K
• 卷排序：6

文摘

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.