Embolization of a left uterine artery mycotic aneurysm after a neglected, perforated appendicitis before delivery

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Obstetrics & Gynecology

Background:

• Mycotic aneurysms are infections of the arterial wall, posing a significant risk of rupture and hemorrhage.
• Neglected perforated appendicitis can lead to severe intra-abdominal sepsis and secondary complications.
• Uterine artery aneurysms, though rare, can occur in the puerperium and present with significant morbidity.

Observation:

• A postpartum patient presented with a mycotic aneurysm of the left uterine artery.
• The aneurysm was a consequence of a neglected perforated appendicitis with subsequent sepsis.
• The clinical presentation highlighted the potential for serious vascular complications from intra-abdominal infections.

Findings:

• Successful endovascular embolization of the mycotic left uterine artery aneurysm was performed.
• The interventional procedure effectively excluded the infected arterial segment, preventing rupture.
• This case demonstrates the feasibility and efficacy of embolization in managing complex vascular infections.

Implications:

• Embolization is a viable and less invasive option for treating mycotic uterine artery aneurysms.
• Early recognition and management of appendicitis are crucial to prevent severe complications like mycotic aneurysms.
• This case underscores the importance of multidisciplinary collaboration in managing rare and complex obstetric and vascular emergencies.