title: Coital injury requiring internal iliac artery ligation.
abstract: Profuse bleeding after voluntary sexual intercourse is an uncommon reason for admission to the gynaecological wards. Out of 12 such patients admitted to the Ipoh Hospital over a three-year period, one patient had life-threatening upper vaginal injury after coitus. Blood replacement and conventional suturing failed to arrest the bleeding. Bilateral internal iliac artery ligation promptly arrested further haemorrhage. Vigorous intercourse increases intra-abdominal pressure in women causing tensing of the cul-de-sac, decreasing the elasticity of the posterior fornix, resulting in vaginal laceration. Bilateral internal iliac artery ligation produces a 'pelvic compartment hypotension' converting a high arterial flow system to that of a low one resembling venous flow. The useful role of this procedure to contain pelvic haemorrhage is discussed.
authors.affiliation: Department of Obstetrics & Gynaecology, Ipoh General Hospital, Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Sivalingam
authors.forename: D
authors.initials: D
authors.lastname: Rajesvaran
mesh_terms: D000328:Adult; D003075:Coitus; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008026:Ligation; D014621:Vagina / Q000293:injuries*; D014623:Vaginal Diseases / Q000209:etiology* / Q000601:surgery