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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
833
Uterine artery pseudoaneurysm after uterine cervical conization
Joses Jain1, Sharon O'Leary, Michael Sarosi
1Departments of Obstetrics and Gynecology and Radiology, St. Joseph Mercy Hospital, Ann Arbor, Michigan.
Obstetrics and Gynecology
|January 14, 2014
Summary
Uterine artery pseudoaneurysm, a rare complication after cervical procedures, can cause significant vaginal bleeding. Prompt diagnosis and embolization are crucial for effective treatment.
Area of Science:
- Gynecologic Surgery
- Vascular Interventions
- Diagnostic Imaging
Background:
- Uterine artery pseudoaneurysm is a rare but serious postoperative complication.
- It most commonly presents as delayed vaginal hemorrhage after cesarean deliveries.
- This case highlights its occurrence following cervical cold-knife conization.
Observation:
- A 26-year-old woman experienced recurrent vaginal hemorrhage post-cervical conization.
- Initial treatments including suture, prothrombotic agents, and ferric subsulfate were ineffective.
- Arteriography initially failed to identify the source of bleeding.
Findings:
- A pseudoaneurysm of the right uterine artery was ultimately diagnosed via repeat bilateral iliac and uterine arteriography.
- The pseudoaneurysm was successfully treated with uterine artery embolization.
- Embolization resolved the patient's symptoms of vaginal hemorrhage.
Implications:
- Cervical conization can lead to uterine artery injury and pseudoaneurysm formation.
- Persistent vaginal hemorrhage after cervical procedures warrants investigation for uterine artery pseudoaneurysm.
- Arteriography may require careful and repeated examination to diagnose pseudoaneurysms.
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