Uterine artery pseudoaneurysm bleeding one decade after caesarean section: A case report

Uterine artery pseudoaneurysm (UAP) can cause severe secondary post-partum hemorrhage. The lag time between the triggering event and the manifestation of UAP reportedly usually occurs within a couple of weeks. In this case report, a 46-year-old woman with no significant comorbidities presented with a one-month history of increasing lower abdominal pain. She had previously undergone two cesarean sections (14 and 10 years earlier). A computed tomography angiogram revealed a left UAP. The patient was successfully treated by selective embolization and had an uneventful recovery. In our case, the time period between the cesarean section and presentation was approximately 10 years with no other potential causative factors. This case highlights that UAP should be included as a differential diagnosis in all female patients presenting with pelvic pain and pelvic bleeding. More specifically, UAP should be considered after a previous history of cesarean section, as a delayed diagnosis can result in serious morbidity and even mortality.