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Published on: January 17, 2019
Pyomyoma after uterine artery embolization: A case report
Dima Ezzedine1, Chima Ndubizu1, Sohaib Kayani1
1Obstetrics and Gynecology Department, Maimsonides Medical Center, Brooklyn, NY 11219, United States of America.
Background:
Uterine pyomyoma is a rare complication of uterine artery embolization (UAE), and causes significant morbidity and mortality. This report describes the diagnosis and prompt management of this condition.
Case:
A 48-year-old woman presented with fever, chills, and diffuse abdominal pain 15 days after undergoing UAE for symptomatic fibroids. Computed tomography showed the uterus to be significantly distended, with multiple intra-cavitary masses containing a large amount of gas and air-fluid level. Sepsis secondary to post-UAE pyomyoma was suspected. Hemodynamic resuscitation and broad-spectrum antibiotics were immediately started. The patient underwent emergency exploratory laparotomy with total hysterectomy.
Conclusion:
In order to ensure appropriate and timely intervention, the diagnosis of uterine pyomyoma should be considered in patients presenting with signs of infection and abdominal pain after UAE.

