title: Transvaginal sonographic findings of a large intramural uterine hematoma associated with iatrogenic injury sustained at termination of pregnancy.
abstract: We report a case in which a patient presented with severe right lower abdominal pain associated with nausea and vomiting 3 days after termination of pregnancy. Transvaginal ultrasonography showed a large intramural mass in the anterior aspect of the lower segment of an acutely retroflexed uterus. Computed tomography and magnetic resonance imaging findings were consistent with an intramural hematoma as a result of iatrogenic injury sustained during the preceding termination of pregnancy. The patient was managed expectantly. Systematic review of the literature confirmed that this is the first report of sonographic findings associated with an intramural uterine hematoma some days after the injury sustained at termination of pregnancy. This case supports utilization of real-time ultrasound guidance during intrauterine surgery of selected cases to decrease procedure-related morbidity.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY 11203-2098, USA. dmsherer@aol.com
authors.forename: D M
authors.initials: DM
authors.lastname: Sherer
authors.forename: C
authors.initials: C
authors.lastname: Gorelick
authors.forename: N
authors.initials: N
authors.lastname: Gabbur
authors.forename: D
authors.initials: D
authors.lastname: Borowski
authors.forename: E
authors.initials: E
authors.lastname: Serur
authors.forename: H L
authors.initials: HL
authors.lastname: Zinn
authors.forename: M
authors.initials: M
authors.lastname: Kheyman
authors.forename: O
authors.initials: O
authors.lastname: Abulafia
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects*; D000293:Adolescent; D005260:Female; D006406:Hematoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007049:Iatrogenic Disease; D008279:Magnetic Resonance Imaging / Q000379:methods; D011247:Pregnancy; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography; D014595:Uterine Perforation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology