Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Inferior Mesenteric Artery Embolization with N-Butyl Cyanoacrylate for Life-Threatening Postpartum Hemorrhage: A Report of Two Cases and Literature Review

치명적 산후출혈에서 N-Butyl Cyanoacrylate를 이용한 하장간막동맥 색전술: 두 개의 증례 보고와 문헌 고찰

  • Hae Won Yoo (Department of Radiology, Dankook University Hospital) ;
  • Min Jeong Choi (Department of Radiology, Dankook University Hospital) ;
  • Bong Man Kim (Department of Radiology, Dankook University Hospital)
  • 유해원 (단국대학교병원 영상의학과) ;
  • 최민정 (단국대학교병원 영상의학과) ;
  • 김봉만 (단국대학교병원 영상의학과)
  • Received : 2020.10.23
  • Accepted : 2020.11.22
  • Published : 2021.05.01
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Abstract

The inferior mesenteric artery is a rare source of postpartum hemorrhage. We report two cases of primary postpartum hemorrhage that originated from the inferior mesenteric artery after vaginal delivery. Both patients showed signs of hypovolemic shock, and disseminated intravascular coagulation was suspected. The bleeding continued even after embolization of the uterine artery, a typical source of postpartum hemorrhage. Inferior mesenteric arteriography confirmed contrast extravasation from the superior rectal artery, and selective embolization was performed using N-butyl cyanoacrylate. This report highlights that the inferior mesenteric artery can be a source of bleeding in patients with intractable and persistent postpartum hemorrhage due to birth canal injury.

하장간막동맥은 산후출혈의 매우 드문 출혈 혈관이다. 저자들은 질분만 후 하장간막동맥에서 출혈이 있었던 일차성 산후출혈 두 개의 증례를 보고한다. 두 환자 모두 저혈량성 쇼크의 징후를 보이고 있었고, 파종성혈관내응고가 의심되는 상태였다. 산후출혈의 흔한 출혈 혈관인 자궁동맥을 색전한 후에도 출혈은 지속되었다. 하장간막동맥 혈관조영술에서 상직장동맥으로부터 조영제의 혈관외누출이 확인되어 N-butyl cyanoacrylate를 이용한 선택적 색전술을 시행하였다. 이 증례를 통해 산도 손상에 의한 산후출혈이 조절되지 않고 지속될 때 하장간막동맥이 출혈 동맥일 수 있다는 점을 강조하고자 한다.

Keywords

References

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