BACKGROUND: Uterine artery pseudoaneurysm is a rare postoperative complication. Several case reports describe this occurring after cesarean deliveries, typically presenting as delayed postoperative bleeding.
CASE: A 26-year-old woman (gravida 1, para 0010) underwent a cervical cold-knife conization. She later presented three times over the subsequent 18 days with intermittent vaginal hemorrhage. After unsuccessful treatment with suture, prothrombotic agents, and ferric subsulfate, arteriography was performed with no abnormality identified. A bilateral iliac and uterine arteriography was repeated to facilitate prophylactic uterine artery embolization. A pseudoaneurysm of the right uterine artery was then visualized and embolized, resolving the symptoms.
CONCLUSION: Injury to the uterine artery causing pseudoaneurysm formation can cause persistent vaginal hemorrhage after cervical conization and may elude diagnosis by arteriography.
Uterine artery pseudoaneurysm formation is a rare but treatable cause of prolonged intermittent hemorrhage after cervical conization.
Departments of Obstetrics and Gynecology and Radiology, St. Joseph Mercy Hospital, Ann Arbor, Michigan.
Corresponding author: Joses Jain, MD, 5333 McAuley Drive, Suite R-2110, Ypsilanti, MI 48197; e-mail: firstname.lastname@example.org.
Financial Disclosure The authors did not report any potential conflicts of interest.