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BMC Women's Health Aug 2021The formation of a uterine artery pseudoaneurysm is rare and isolated cases have been reported in the existing literature following caesarean sections, curettages and...
BACKGROUND
The formation of a uterine artery pseudoaneurysm is rare and isolated cases have been reported in the existing literature following caesarean sections, curettages and cone biopsies. There has been no report of pseudoaneurysm formation following a loop electrosurgical excision procedure. Vaginal bleeding could potentially be life threatening if this diagnosis is not considered following cervical instrumentation or surgery. Management options range from haemostatic sutures, image-guided embolisation to surgical repair. We report the diagnosis and management of a case of uterine artery pseudoaneurysm after a loop electrosurgical excision procedure.
CASE PRESENTATION
A 37-year-old woman was diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3) and underwent a therapeutic loop electrosurgical excision procedure. One month after the procedure, the patient presented to the emergency department with repeated episodes of sudden-onset heavy vaginal bleeding associated with hypotension and syncope. A computed tomography angiogram was performed, which demonstrated a pseudoaneurysm of the right uterine artery. Following the diagnosis, image-guided embolisation was performed successfully. Post-embolisation angiograms showed successful embolisation of the pseudoaneurysm and the patient had no further episodes of bleeding.
CONCLUSIONS
Loop electrosurgical excision procedures are generally safe but rarely, can be complicated by the formation of uterine artery pseudoaneurysms. The depth of the loop electrosurgical excision procedure and vascular anatomy should be considered to prevent such complications. A computed tomography angiogram appears to be ideal for diagnosis. Image-guided embolisation is safe and effective as a therapeutic measure, with minimal morbidity.
Topics: Adult; Aneurysm, False; Electrosurgery; Female; Humans; Pregnancy; Uterine Artery; Uterine Cervical Neoplasms; Uterine Hemorrhage
PubMed: 34399742
DOI: 10.1186/s12905-021-01446-7 -
Pediatric Emergency Care Dec 2019Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous... (Review)
Review
Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous fistula, foreign objects, and ganglion cysts, as well as tumors. They are associated with distinguishing findings of "pulsatile mass, a palpable thrill, and an audible to-and-fro murmur" (1), which can be confirmed by various imaging techniques. In this report, we describe the case of a 4-year-old boy who presented to the pediatric emergency department 3 weeks after falling and subsequently getting cut by glass. Upon clinical examination, the patient presented with pulsatile, swollen mass in the left wrist. A Doppler ultrasound of the left wrist demonstrated that the area of clinical concern in the left wrist showed a pseudoaneurysm, and prominent arterial blood flow was seen within the pseudoaneurysm. Because pseudoaneurysms, particularly posttraumatic pseudoaneurysms, are extremely rare in the pediatric population, it may be easy to miss these cases during clinical examination. Misdiagnosis of the pseudoaneurysm can cause delayed treatment, a longer recovery period, and complications such as infection, rupture, and hemorrhage. It is important for physicians to consider this entity when evaluating patients with symptoms of asymptomatic bulges to painful pulsatile masses after trauma.
Topics: Adolescent; Aneurysm, False; Child; Child, Preschool; Diagnostic Errors; Female; Humans; Male; Neoplasms, Post-Traumatic; Radial Artery; Treatment Outcome; Ultrasonography, Doppler; Vascular Grafting; Wrist
PubMed: 28719480
DOI: 10.1097/PEC.0000000000001236 -
American Journal of Orthopedics (Belle... May 2015Traction pins are an essential tool in the orthopedic surgeon's armamentarium. Historically a definitive treatment for some fractures, they are mainly used as a... (Review)
Review
Traction pins are an essential tool in the orthopedic surgeon's armamentarium. Historically a definitive treatment for some fractures, they are mainly used as a temporizing measure today. Despite their frequent use and relative simplicity, traction pins can have complications, many of which can be subtle and easily overlooked. Here we report on an unusual complication that was difficult to diagnose but caused significant morbidity before being diagnosed and treated. Pseudoaneurysms can cause a range of symptoms and usually present as a painful, tender, pulsatile mass, but in this instance the popliteal artery pseudoaneurysm presented as chronic, painful lower extremity swelling. With diagnosis and treatment, the patient's symptoms resolved. We discuss the complications associated with traction-pin placement.
Topics: Aneurysm, False; Bone Nails; Embolization, Therapeutic; Female; Femur Head; Hip Dislocation; Hip Fractures; Humans; Popliteal Artery; Tibia; Traction; Young Adult
PubMed: 25950546
DOI: No ID Found -
Journal of Vascular Surgery Aug 1993A 4-year-old male child was admitted with a large 12 x 15 cm suprarenal abdominal aortic pseudoaneurysm 7 months after an episode of blunt abdominal trauma.... (Review)
Review
A 4-year-old male child was admitted with a large 12 x 15 cm suprarenal abdominal aortic pseudoaneurysm 7 months after an episode of blunt abdominal trauma. Aneurysmorrhaphy was performed through a left thoracoabdominal approach with Dacron patch aortoplasty. This report summarizes this case and reviews the literature on abdominal aortic pseudoaneurysms after blunt abdominal trauma.
Topics: Abdominal Injuries; Aneurysm, False; Aortic Aneurysm, Abdominal; Child Abuse; Child, Preschool; Humans; Male; Time Factors; Wounds, Nonpenetrating
PubMed: 8350441
DOI: No ID Found -
Progres En Urologie : Journal de... Jan 2015Partial nephrectomy (PN) has become the gold standard for the treatment of small tumors confined to the kidney. As result, the number of PN procedures increased during... (Review)
Review
BACKGROUND
Partial nephrectomy (PN) has become the gold standard for the treatment of small tumors confined to the kidney. As result, the number of PN procedures increased during the last years. Subsequently, we have more often to deal with the complications of this surgery. Among these, pseudoaneurysms are rare but potentially life-threatening due to a risk of bleeding. Therefore, pseudoaneurysms have to be treated according to a relevant strategy.
METHODS
We performed a literature review of the cases of pseudoaneurysm after PN was reported as well as a focus on the different treatment strategies and their outcomes.
RESULTS
The incidence of pseudoaneurysm is low, ranging from 0.5% to 4%. Radio-embolization represents the gold standard treatment, used in 98% of the cases reported in the literature, allowing high success rate and rare morbidity. However, in some selected cases, surveillance could be an alternative.
Topics: Aneurysm, False; Diagnostic Imaging; Embolization, Therapeutic; Humans; Nephrectomy; Renal Artery
PubMed: 25450752
DOI: 10.1016/j.purol.2014.09.042 -
Ear, Nose, & Throat Journal Dec 2022Internal maxillary artery (IMA) pseudoaneurysms are rare, and typically occur following trauma or orthognathic surgery. Pseudoaneurysms are life-threatening conditions,... (Review)
Review
Internal maxillary artery (IMA) pseudoaneurysms are rare, and typically occur following trauma or orthognathic surgery. Pseudoaneurysms are life-threatening conditions, and expeditious workup and treatment is critical. Endoscopic treatment of an IMA pseudoaneurysm is a feasible option and should be considered when IR embolization is not available. The objective of this study is to review the literature on IMA pseudoaneurysms and present the first reported case of an IMA pseudoaneurysm successfully treated endoscopically.
Topics: Humans; Maxillary Artery; Aneurysm, False; Endoscopy; Embolization, Therapeutic
PubMed: 36047445
DOI: 10.1177/01455613221121443 -
Journal of the American Society of... Apr 1997A pseudoaneurysm is a pulsatile hematoma that communicates with an artery through a disruption in the arterial wall. Femoral pseudoaneurysm is a common complication of... (Review)
Review
A pseudoaneurysm is a pulsatile hematoma that communicates with an artery through a disruption in the arterial wall. Femoral pseudoaneurysm is a common complication of invasive procedures. It occurs in 0.1% to 0.2% of diagnostic angiograms and 3.5% to 5.5% of interventional procedures. Longer procedures, large-bore catheters, anticoagulation, and a faulty lower site of puncture are associated with a higher incidence of femoral pseudoaneurysm. Pseudoaneurysms are associated with the characteristic findings of a pulsatile mass, a palpable thrill, and an audible to-and-fro murmur. The diagnosis is confirmed by imaging of the pseudoaneurysm. A femoral arterial duplex study is the diagnostic imaging modality of choice. It can show the pseudoaneurysm, the degree of clotting, the communication with the femoral artery, and the blood flow velocity pattern within the artery, the communication, and the pseudoaneurysm. Small (less than 2 cm) femoral pseudoaneurysms clot spontaneously and usually require no treatment. Larger femoral pseudoaneurysms may lead to complications including rupture and compression of the adjacent femoral vein (with resulting venous thrombosis) or of the femoral nerve. Treatment may be surgical. However, recently it has been shown that direct, noninvasive compression of the pseudoaneurysm stops the blood flow in the communication and leads to pseudoaneurysm clotting and obliteration.
Topics: Aneurysm, False; Catheterization, Peripheral; Femoral Artery; Humans; Iatrogenic Disease; Ultrasonography
PubMed: 9109690
DOI: 10.1016/s0894-7317(97)70061-0 -
Annali Italiani Di Chirurgia May 2022A 35-year-old woman, chronic alcoholic, was admitted for an attack of acute, necrotizing pancreatitis. Antibiotics and percutaneous drainage failed to control the septic...
A 35-year-old woman, chronic alcoholic, was admitted for an attack of acute, necrotizing pancreatitis. Antibiotics and percutaneous drainage failed to control the septic status and the pancreatic collection. Open surgery allowed a successful necrosectomy and drainage. However, a control CT scan before removal of drains showed a 1 cm diameter pseudoaneurysm of the cystic artery, not present at previous abdominal imaging. A redo laparotomy was performed followed by cholecystectomy with en bloc resection of the pseudoaneurysm and a second look of the peripancreatic area. The patient made an uneventful recovery and was discharged on postoperative day 5. Pseudoaneurysms of the cystic artery after acute necrotizing pancreatitis are very rare. Percutaneous embolization is effective in controlling the pseudoaneurysm, but requires subsequent cholecystectomy within a short delay, due to the risk of gangrene of the gallbladder requiring a further, emergency surgical treatment. Open resection of the pseudoaneurysm en bloc with cholecystectomy appears, therefore, an appropriate treatment of this rare condition. KEY WORDS: Cystic artery, Pancreatitis, Pseudoaneurysm.
Topics: Adult; Aneurysm, False; Cholecystectomy; Female; Hepatic Artery; Humans; Pancreatitis, Acute Necrotizing
PubMed: 36065811
DOI: No ID Found -
Journal of Vascular Surgery Feb 1998Renal artery pseudoaneurysms are rare after blunt abdominal trauma; only 11 cases have been previously reported. Pseudoaneurysms are caused by decelerating injuries of... (Review)
Review
Renal artery pseudoaneurysms are rare after blunt abdominal trauma; only 11 cases have been previously reported. Pseudoaneurysms are caused by decelerating injuries of the renal artery after major falls or automobile accidents. Patients may be asymptomatic for many years, and the pseudoaneurysm may expand and rupture before diagnosis or treatment. The patients in four untreated cases died. The diagnosis of renal artery pseudoaneurysm can be made by Doppler sonography, computerized tomography, renal perfusion imaging, or contrast angiography. Treatment requires either surgical or percutaneous intervention. Renal salvage was possible in five of the seven patients treated. We report two additional patients with successful outcomes after surgical intervention.
Topics: Abdominal Injuries; Adolescent; Adult; Aneurysm, False; Female; Humans; Renal Artery; Time Factors; Wounds, Nonpenetrating
PubMed: 9510292
DOI: 10.1016/s0741-5214(98)70368-4 -
General Thoracic and Cardiovascular... May 2022The ventricular pseudo-pseudoaneurysm is extremely scarce and potentially lethal because of acute hemopericardium and cardiac tamponade when a resultant complete tear...
The ventricular pseudo-pseudoaneurysm is extremely scarce and potentially lethal because of acute hemopericardium and cardiac tamponade when a resultant complete tear occurs. Pseudo-pseudoaneurysms, which are formed by incomplete rupture of the myocardium, are usually small and limited to the thickness of the cardiac wall. We reported an uncommon case of a giant left ventricular pseudo-pseudoaneurysm, which was initially suspected by transthoracic echocardiography as a pseudoaneurysm.
Topics: Aneurysm, False; Cardiac Tamponade; Echocardiography; Heart Aneurysm; Heart Ventricles; Humans; Myocardial Infarction; Rupture
PubMed: 34982374
DOI: 10.1007/s11748-021-01769-0