Super-selective angiographic embolisation of a branch of the anterior pudendal artery for the treatment of intractable post-operative bleeding.
We describe a case of post-operative bleeding after a posterior fascial defect repair. This was refractive to exploration and vaginal packing so laparotomy would have been necessary. Superselective cannulation demonstrated bleeding from a branch of the anterior pudendal artery which had crossed the midline making identification difficult during vaginal exploration. The bleeding vessel was embolised using a mixture of PVA300 and Spongistan gel foam and the bleeding ceased. The use of embolisation in the peri-operative phase is discussed.
Phillips
C
C
The Princess Anne Hospital, Coxford Road, Southampton, SO165YA, UK. phillipschaps@aol.com
Hacking
N
N
Monga
A
A
D000792:Angiography; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000628:therapy*; D020047:Rectocele / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery; D014621:Vagina / Q000098:blood supply* / Q000601:surgery
D006490:Hemostatics; D011142:Polyvinyl Alcohol