Uterine artery embolization for control of life-threatening hemorrhage at menarche: brief report.
Uncontrolled acute menorrhagia resulting in hemodynamic instability in the adolescent is uncommon. We report a case of life-threatening menorrhagia upon first menses in a 12-year-old girl who was successfully treated with uterine artery embolization after failure of standard gynecologic and medical measures. Testing eventually revealed a coagulopathy that resulted from decreased plasminogen activator inhibitor-1 activity in combination with an immature hypothalamic-pituitary-ovarian axis. Coagulation disorders are more common in patients presenting with severe menorrhagia upon menarche. Interventional radiologists should be aware of such coagulation abnormalities and the differences between adults and adolescents when contemplating uterine artery embolization for adolescent patients.
Bowkley
Charles W
CW
Rhode Island Hospital, Department of Diagnostic Imaging, Brown Medical School, Providence, RI 02903, USA.
Dubel
Gregory J
GJ
Haas
Richard A
RA
Soares
Gregory M
GM
Ahn
Sun H
SH
D001778:Blood Coagulation Disorders / Q000150:complications / Q000175:diagnosis*; D002648:Child; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008572:Menarche; D008595:Menorrhagia / Q000209:etiology / Q000628:therapy*; D017395:Plasminogen Activator Inhibitor 1 / Q000172:deficiency; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000628:therapy*; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology
D017395:Plasminogen Activator Inhibitor 1