title: Compression-refractory breast hematoma secondary to pseudoaneurysm after stereotactically guided vacuum-assisted biopsy: the critical role of urgent surgical evacuation.
abstract: We report the case of a patient who underwent a vacuum-assisted biopsy of amorphous clustered microcalcifications complicated by a large compression-refractory hematoma secondary to pseudoaneurysm formation. Breast sonography was used to identify an actively bleeding vessel and guide compression. However, due to its unresponsiveness to conventional management and rapid progression, the hematoma required surgical evacuation and ligation of the bleeding vessel. This suggests that, in the face of significant intractable bleeding, a heightened awareness of the possible need for surgical intervention should be maintained.
authors.affiliation: Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec, H3H 1A1, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Sun
authors.forename: Hooman
authors.initials: H
authors.lastname: Hennessey
authors.forename: Idris
authors.initials: I
authors.lastname: Kam Nakch
authors.forename: Shaza
authors.initials: S
authors.lastname: Alsharif
authors.forename: Sarkis
authors.initials: S
authors.lastname: Meterissian
authors.forename: Benoît
authors.initials: B
authors.lastname: Mesurolle
mesh_terms: D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis*; D001941:Breast Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D004322:Drainage / Q000379:methods*; D004630:Emergencies; D005260:Female; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008323:Mammary Arteries; D008875:Middle Aged; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014618:Vacuum
keywords: breast ultrasonography; drainage; hematoma; pseudoaneurysm; vacuum-assisted biopsy