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Updated: Apr 26, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Acute pulmonary embolism caused by enlarged uterine leiomyoma: a rare presentation
Kamal Khademvatani1, Yousef Rezaei2, Abdollah Kerachian1
1Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
Patient:
Female, 42.
Final Diagnosis:
Acute pulmonary embolism.
Symptoms:
Chest pain • dyspnea.
Medication:
Streptokinase • Warfarin.
Clinical Procedure:
.-
Specialty:
Cardiology and Neoplasm.
Objective:
Management of emergency care.
Background:
Deep venous thrombosis (DVT) and subsequent pulmonary embolism (PE) caused by pelvic vein compression are rare and life-threatening complications of leiomyoma of the uterus.
Case Report:
We report a 42-year-old virgin woman with a history of leiomyoma who presented to the emergency department with complaints of dyspnea and pleuritic chest pain with transient spotting. On physical examination, she had a non-tender abdomen with a 20-week size uterus. Imaging investigations revealed an acute DVT in her left leg and a huge uterine-derived mass compressing the common iliac veins. Transesophageal echocardiography (TEE) demonstrated an echogenic mass in her right pulmonary artery consistent with thrombosis. The patient was completely cured using thrombolytic therapy and myomectomy, and was well at 1 year after thrombolysis.
Conclusions:
PE caused by pelvic vein compression is a rare complication of leiomyoma, which should be considered. Thrombolytic therapy associated with myomectomy can be implemented for treating such cases, and TEE can be used for diagnosing suspected high-risk PE.
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