Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Uterine Artery Embolization as an Effective Management and Diagnostic Tool for Puerperal Uterine Inversion with Severe Postpartum Bleeding: A Case Report

자궁내번증으로 인한 중증 산후 출혈 환자에서 효율적인 조치 및 진단적 도구로서의 자궁동맥색전술: 증례 보고

  • Seong Ju Kim (Department of Radiology, GangNeung Asan Hospital) ;
  • Youngjong Cho (Department of Radiology, GangNeung Asan Hospital) ;
  • Sung-Joon Park (Department of Radiology, Korea University Ansan Hospital) ;
  • Sangjoon Lee (Department of Radiology, Pohang St. Mary's Hospital) ;
  • Hyoung Nam Lee (Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital) ;
  • Da Hye Ju (Department of Obstetrics and Gynecology, GangNeung Asan Hospital)
  • 김승주 (강릉아산병원 영상의학과) ;
  • 조영종 (강릉아산병원 영상의학과) ;
  • 박성준 (고려대학교 안산병원 영상의학과) ;
  • 이상준 (포항성모병원 영상의학과) ;
  • 이형남 (순천향대학교 의과대학 천안병원 영상의학과) ;
  • 주다혜 (강릉아산병원 산부인과)
  • Received : 2021.04.11
  • Accepted : 2021.07.26
  • Published : 2022.05.01
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Abstract

Acute puerperal uterine inversion is a rare postpartum obstetric complication; however, without rapid diagnosis and appropriate management, it is life-threatening. Substantial bleeding hinders the verification of a partially inverted uterus, possibly delaying the treatment. Herein, we present the report of a 32-year-old female presenting with massive postpartum bleeding managed by uterine artery embolization. The peculiar course of the uterine artery bowing inferiorly along the inverted fundus during embolization could uncover the uterine inversion, which was not diagnosed by physical examination and CT. In conclusion, uterine artery embolization is not only an effective therapeutic strategy for postpartum hemorrhage but also a valuable tool for diagnosing uterine inversion.

급성 산후 자궁내번증은 드문 산후합병증의 하나이나 생명을 위협할 수 있어 신속한 진단 및 적절한 치료가 중요하다. 다량의 출혈은 부분 자궁내번증을 진단하는데 어려움을 야기하며 치료를 지연시킬 수 있다. 본 증례는 다량의 산후 출혈을 주소로 온 32세 산모를 자궁동맥색전술을 통해 내번된 자궁의 기저부를 따라서 아래쪽으로 기울어져 주행하는 자궁동맥의 특이적인 주행을 발견하여 자궁내번증으로 빠르게 진단할 수 있었던 증례이다. 이를 통해 자궁동맥색전술은 효율적인 치료를 위한 중재시술뿐만 아니라 자궁내번증의 진단적 도구로 가치가 있음을 보여준다.

Keywords

References

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