Percutaneous angiographic arterial embolization for gynecologic and obstetric pelvic hemorrhage. A report of three cases.
Percutaneous angiographic arterial embolization for control of intractable hemorrhage is being utilized increasingly in general surgery and trauma patients. Recently there have been several reports on the application of this technique in patients experiencing bleeding from the pelvic vasculature. We describe our management of three patients by percutaneous iliac arterial angiographic embolization. One patient, following repeat cesarean section for a twin gestation, developed intraabdominal bleeding that failed to respond to classic maneuvers, including cesarean hysterectomy. A second patient suffered a deep vaginal sulcus tear during spontaneous vaginal delivery. The third patient developed a hemorrhage from the vaginal cuff 31 days after vaginal hysterectomy. In each case, angiography demonstrated extravasation of dye from a branch of the hypogastric artery. Selective embolization was uniformly successful in quickly achieving hemostasis. There were no major complications associated with the procedure.
Joseph
J F
JF
Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts.
Mernoff
D
D
Donovan
J
J
Metz
S A
SA
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D014623:Vaginal Diseases / Q000628:therapy*