Document Detail


Necrotic leiomyoma and gram-negative sepsis eight weeks after uterine artery embolization.
MedLine Citation:
PMID:  15516437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Uterine artery embolization for symptomatic leiomyomata is generally safe, but rare life-threatening complications, including sepsis, can result. CASE: A 39-year-old woman with primary antiphospholipid syndrome, who was on chronic warfarin therapy, underwent uterine artery embolization for severe menorrhagia and a 12-cm intracavitary leiomyoma. Eight weeks postembolization, the patient, who had been essentially asymptomatic, presented in septic shock from gram-negative anaerobic bacteria. She underwent hysterectomy and bilateral salpingo-oophorectomy for a large infarcted necrotic leiomyoma and partial uterine necrosis. The patient's 8-day hospitalization required extended care in the intensive care unit and blood transfusion and resulted in surgical menopause in a patient who is not a candidate for hormone therapy. CONCLUSION: Uterine artery embolization is a procedure not without significant risks. From published case reports, it appears that patients most at risk for severe infection of an infarcted leiomyoma after this procedure are those with a large dominant leiomyoma.
Authors:
Matthew Aungst; Mark Wilson; Karen Vournas; Sarah McCarthy
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  104     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-01     Completed Date:  2005-01-04     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1161-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, David Grant Medical Center, Travis Air Force Base, California, USA. Mathew.aungst@60mdg.travis.af.mil
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents
Combined Modality Therapy
Drug Therapy, Combination / therapeutic use
Embolization, Therapeutic / adverse effects*,  methods
Female
Follow-Up Studies
Gram-Negative Bacterial Infections / diagnosis,  etiology*,  therapy
Humans
Hysterectomy / methods
Infusions, Intravenous
Leiomyoma / pathology,  therapy*
Necrosis / pathology
Ovariectomy / methods
Severity of Illness Index
Shock, Septic / diagnosis,  etiology*,  therapy
Tomography, X-Ray Computed
Treatment Outcome
Uterine Neoplasms / pathology,  therapy*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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