PMC2642857_01
Three-dimensional transvaginal ultrasound scan (in multiplane acquisition mode) of the uterus-hematoma-bladder complex (UT, HM, BD respectively). Please note that the white pixel (placed in the center of each image) always correspond with the same space point of the three orthogonal planes, and is located referring HM, between UT (at the level of the uterine scar) and just beneath BD. Defect's surface three-dimensional reconstruction (of the coronal plane) correspond with bottom right picture, and is framed with a white arrow (instead of white pixel).
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F1
The bladder wall was not involved (Figure 1).
Two-dimensional transvaginal uterine (UT) ultrasound on longitudinal plane showing the communication (arrow) of the hematoma (HM) with the endometrial cavity (EC).
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F2
The lower uterine segment had a 9 x 12 mm wall defect and an anechoic track that seemed to communicate the blood collection with the endometrial cavity (Figure 2).
Intra-operative picture showing the defect on the lower uterine segment after dissection (arrow).
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F3
Finally, the treatment performed was an abdominal hysterectomy and the pathologic study confirmed the process as being of ischemic origin (Figures 3 and 4).
Pathological image of the uterus showing the defect.
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F4
Finally, the treatment performed was an abdominal hysterectomy and the pathologic study confirmed the process as being of ischemic origin (Figures 3 and 4).