Control de la hemorragia grave en la miomectomía con taponamiento pélvico: un informe de caso

Interventions for controlling uterine bleeding during myomectomy, abound. When, however, the haemorrhage arises from low pressure bleeders in the retropelvic space and threatens patient's exsanguination, hitherto unknown interventions become life-saving. The aim of this report is to bring to fore a case of profuse, unprecedented myomectomy-associated retropelvic haemorrhage that was successfully controlled with combined transvaginal and transabdominal pelvic mop packing. A multipara, who presented with a 2-year history of symptomatic uterine fibroids. Intra-operatively, she developed profuse haemorrhage after the excision of a submucous fundal fibroid in the retro-pelvic space. Two abdominal mops pushed trans-vaginally to pack the pelvis reduced the bleeding by 80%, and a transabdominal mop exerting pressure on the transvaginal mops stopped bleeding entirely. The mops were removed after 48 hours, and she recovered uneventfully. Deep pelvic haemorrhage complicating myomectomy may be successfully stopped by combined transvaginal and transabdominal pelvic packing to save life.