BACKGROUND: Life-threatening abnormal uterine bleeding can be managed by a variety of techniques, which include intravenous estrogen, dilation and curettage, endometrial ablation, uterine artery embolization, or hysterectomy. Thermal balloon endometrial ablation has been used in the management of chronic dysfunctional uterine bleeding but has not been described in a case of acute uterine hemorrhage.
CASE: A 44-year-old woman with end-stage liver disease presented with vaginal bleeding and fever. She was found to have sepsis, coagulopathy, and anemia. No anatomic uterine pathology was identified. Antibiotics, intravenous estrogen, and blood products were administered, but heavy bleeding persisted. Thermal balloon ablation resulted in abrupt cessation of uterine bleeding.
CONCLUSION: Thermal balloon ablation appears to be an effective method for management of acute uterine hemorrhage.