PMC9661432_01
(A) Aortography after placement of 5F right femoral catheter, showing no active bleeding. (B) The selective introduction of a catheter into the right uterine artery shows active bleeding into the peritoneal cavity. (C) Angiography after injection of resorbable gelatin sponge shows slight but persistent, active bleeding. (D) After placement of the microcoils (arrow), angiography shows satisfactory occlusion of the uterine artery without active bleeding. (E) Enhanced CT scan in coronal section the day after embolization shows a gravid uterus associated with a right latero-uterine hematoma (star) with retention of contrast medium (dotted arrow), associated with a defect in enhancement and air the right uterine wall (arrow). (F) CT scan in coronal section performed 1 month after AUE shows a reduction in the size of the hematoma (star) and a restitution ad-integrum of the uterine wall.
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After placement of a 4F introducer by right femoral approach under local anesthesia, a 4F pig tail catheter was introduced (Fig. 1).
PMC9661432_02
(A) CT scan without contrast injection in coronal section showing a large left lateropelvic hematoma (star) in contact with the gravid uterus (arrow). (B) CT scan with contrast injection shows active left lateropelvic hematoma (arrow) associated with hemoperitoneum (star). (C) Sagittal MIP reconstructions confirm that the bleeding (arrow) is coming from the uterine artery (dotted arrow). (D) Aortography confirms active bleeding. (E) After placement of the coils and embolization with absorbable gelatin, angiography shows satisfactory occlusion of the uterine artery at its ostium. (F) One CT scan in coronal section after injection of contrast medium shows a clear reduction in the size of the hematoma and a complete restitution of the uterine wall.
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An emergency contrasted-enhanced CT scan showed a voluminous left latero-uterine hematoma, and active bleeding in the peritoneum (Fig. 2).